We conducted a retrospective review of all patients with EA at our tertiary care children's hospital. Disease-specific (Spitz, Waterston, and Montreal) and generic prognostic scores (Score for Neonatal Acute Physiology II and Score for Neonatal Acute Physiology-Perinatal Extension) were calculated. Outcomes investigated included mortality and early nonmortality outcomes (leak, stricture, and recurrent fistula). These were assessed individually and as a composite ¡°poor outcome?score. Correlations were sought, and receiver operating characteristic curves were generated.
Fifty patients were included for analysis, with 5 deaths (10 % ) in our series. Eight patients developed a postoperative leak, 18 developed stenosis requiring dilatation, and 2 developed refistulization. Overall, 51 % of survivors had a poor composite outcome. Although no prognostic score achieved statistical significance, the generic scores outperformed the disease-specific scores in predicting early nonmortality outcomes.
Postoperative morbidity remains common in patients with EA. Disease-specific, preexisting prognostic scoring systems do not delineate surviving patients at risk for early complications and appears to underperform when compared with generic prognostic scores.