Statewide Hospital Admissions for Adult Survivors of Infant Surgical Diseases Over a 10-Y Period

Michael P Rogers; Haroon Janjua; Paul C Kuo; Henry L Chang

doi:10.1016/j.jss.2024.04.018

Statewide Hospital Admissions for Adult Survivors of Infant Surgical Diseases Over a 10-Y Period

J Surg Res. 2024 May 16:299:172-178. doi: 10.1016/j.jss.2024.04.018. Online ahead of print.

Authors

Michael P Rogers¹, Haroon Janjua¹, Paul C Kuo¹, Henry L Chang²

Affiliations

¹ Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida.
² Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida; Department of Surgery, John's Hopkins All Children's Hospital, St. Petersburg, Florida. Electronic address: Hchang56@jhmi.edu.

PMID: 38759333
DOI: 10.1016/j.jss.2024.04.018

Abstract

Introduction: The number of patients with congenital disease living to adulthood continues to grow. Often undergoing surgical correction in infancy, they continue to require lifelong care. Their numbers are largely unknown. We sought to evaluate hospital admissions of adult patients with esophageal atresia with tracheoesophageal fistula (EA/TEF), congenital diaphragmatic hernia (CDH), and Hirschsprung disease (HD).

Methods: The Florida Agency for Healthcare Administration inpatient database was merged with the Distressed Communities Index and Centers for Medicare and Medicaid Services Hospital and Physician Compare datasets. The dataset was queried for adult patients (≥18 y, born after 1970) with EA/TEF, CDH, and HD in their problem list from 2010 to 2020. Patient demographics, hospitalization characteristics, and discharge information were obtained.

Results: In total, 1140 admissions were identified (266 EA/TEF, 135 CDH, 739 HD). Patients were mostly female (53%), had a mean age of 31.6 y, and often admitted to an adult internist in a general hospital under emergency. Principal diagnoses and procedures (when performed) varied with diagnosis and age at admission. EA patients were admitted with dysphagia and foregut symptoms and often underwent upper endoscopy with dilation. CDH patients were often admitted for diaphragmatic hernias and underwent adult diaphragm repair. Hirschsprung patients were often admitted for intestinal obstructive issues and frequently underwent colonoscopy but trended toward operative intervention with increasing age.

Conclusions: Adults with congenital disease continue to require hospital admission and invasive procedures. As age increases, diagnoses and performed procedures for each diagnoses evolve. These data could guide the formulation of multispecialty disease-specific follow-up programs for these patients.

Keywords: Adult congenital disease; Congenital diaphragmatic hernia; Esophageal atresia; Hirschsprung disease; Tracheoesophageal fistula.