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Prognostic Factors of Waterston et al in Esophageal Atresia and/or Tracheoesophageal Fistula

Description

Waterston et al identified prognostic factors in infants with esophageal atresia with or without tracheoesophageal fistula in 1962. With improvements in diagnosis and treatment, some of the prognostic factors identified then no longer are as significant today.


 

Prognostic factors identified by Waterston et al:

(1) low birth weight

(2) pneumonia after aspiration present at admission

(3) presence of associated congenital anomalies

Birthweight

Condition

Class

> 5.5 lbs (2,495 grams)

well

A

4.0 to 5.5 pounds

well

B

> 5.5 pounds

moderate pneumonia and/or moderate congenital anomalies

B

< 4 pounds (1,814 grams)

 

C

 

severe pneumonia and/or severe congenital anomalies

C

 

 

Class

Prognosis

A

good

B

intermediate

C

poor

 

Limitations:

• Rokitansky et al (1993) found that the Waterston score no longer accurately predicted outcome in infants with esophageal atresia. Newer diagnostic and treatment modalities had significantly increased survival in low birth weight infants. In addition, aspiration pneumonia can usually be treated successfully. Associated malformations appears to be the only valid prognostic component today.

 


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