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Surgical Interventions and Clinical Outcomes of Patients with Trisomy 18: a Single Center Experience

Perinatology 2020년 31권 3호 p.129 ~ 136
Oh Moon-Yeon, 이병섭, 차태현, 정지윤, 정의석, 김애란, 김기수, 이범희, 유한옥,
소속 상세정보
 ( Oh Moon-Yeon ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
이병섭 ( Lee Byong-Sop ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
차태현 ( Cha Tae-Hyen ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
정지윤 ( Jeong Ji-Yoon ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
정의석 ( Jung Eui-Seok ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
김애란 ( Kim Ai-Rhan ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
김기수 ( Kim Ki-Soo ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
이범희 ( Lee Beom-Hee ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
유한옥 ( Yoo Han-Wook ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics

Abstract


Objective: The purpose of this study was to investigate the impact of surgical interventions on the survival rate of the trisomy 18 and to provide the clinical information of the developmental status of the neonatal intensive care unit (NICU) survivors.

Methods: We retrospectively reviewed the medical records of the patients who were confirmed genetically as trisomy 18 in a tertiary hospital. Patients were divided into those who were treated with active surgical interventions and those who were not (the control group). Data on mortality and long- term developmental outcomes were obtained and compared between the study groups.

Results: A total of 24 patients were included. All of them had major congenital anomalies with a 100% prevalence of congenital heart diseases. The overall survival rate was 75%, and 35% at one month, and one year of age, and the median survival time was 170 days. The one-year survival rate of the group of active surgical intervention (n=14) was 56% with a median survival of 398 days. Meanwhile, none in the control group (n=7) survived for more than three months. The NICU survivors were unable to stand up even after two years of age. Their cognitive and social developmental stages generally consistent with those under six months of age.

Conclusions: Despite the potential survival benefits of active surgical intervention, NICU survivors with trisomy 18 had severe developmental delays. To guide early decision-making for newborns with trisomy 18, further research is needed regarding the quality of life of trisomy 18 survivors and their families.

키워드

Trisomy 18; Surgical interventions; Survival; Prognosis

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