Quality of life outcomes in children born with duodenal atresia

Toby Vinycomb; Alison Browning; Matthew L M Jones; John M Hutson; Sebastian K King; Warwick J Teague

doi:10.1016/j.jpedsurg.2019.11.017

Quality of life outcomes in children born with duodenal atresia

J Pediatr Surg. 2020 Oct;55(10):2111-2114. doi: 10.1016/j.jpedsurg.2019.11.017. Epub 2019 Dec 28.

Authors

Toby Vinycomb¹, Alison Browning¹, Matthew L M Jones², John M Hutson³, Sebastian K King⁴, Warwick J Teague⁵

Affiliations

¹ Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia.
² Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Surgery, University of Sydney, Sydney, Australia.
³ Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Surgery, University of Sydney, Sydney, Australia; Department of Urology, The Royal Children's Hospital, Melbourne, Australia.
⁴ Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Surgery, University of Sydney, Sydney, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia.
⁵ Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Surgery, University of Sydney, Sydney, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia. Electronic address: warwick.teague@rch.org.au.

PMID: 31955988
DOI: 10.1016/j.jpedsurg.2019.11.017

Abstract

Purpose: The aim of this study was to determine long term quality of life (QoL) outcome for children who underwent surgery for duodenal atresia (DA).

Methods: Patients were identified from a prospective database of neonatal DA cases managed at a tertiary pediatric surgical centre. The QoL was measured using the validated PedsQL™ 4.0 core score and PedsQL™ gastrointestinal module; higher score equates to better QoL. Participants' scores were compared to published control cohorts, age-matching the core score. Trisomy 21 was identified a priori as a possible confounder, informing subgroup analyses for children with and without trisomy 21.

Results: Fifty-five families were invited to participate, with 38 surveys returned (39% male; median age 6.7y, range 2.7-17.3y). Seven participants had trisomy 21. There were no differences in QoL measures between all DA participants and controls. The PedsQL™ core score was significantly lower for DA participants with trisomy 21, but there was no accompanying difference in PedsQL™ gastrointestinal score.

Conclusions: Children undergoing DA surgery in the neonatal period typically grow up to have a QoL comparable to a healthy population. Children with DA and trisomy 21 were more likely to have reduced overall QoL, albeit without an associated difference in gastrointestinal QoL score.

Level of evidence: Prognosis study - level II (prospective cohort study).

Keywords: Congenital abnormalities; Duodenal atresia; Duodenal obstruction; Intestinal atresia; Long term outcomes; Quality of life.

MeSH terms

Adolescent
Child
Child, Preschool
Down Syndrome / complications
Duodenal Obstruction* / physiopathology
Duodenal Obstruction* / surgery
Female
Humans
Intestinal Atresia* / physiopathology
Intestinal Atresia* / surgery
Male
Prospective Studies
Quality of Life*

Supplementary concepts

Familial duodenal atresia