Robin sequence: Mortality, causes of death, and clinical outcomes

Melinda A. Costa, Michael M. Tu, Kariuki P. Murage, Sunil S. Tholpady, William A. Engle, Roberto L. Flores

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: The authors report the cause of and risk factors for mortality in infants with Robin sequence and identify characteristics associated with qualityof- life outcomes. Methods: The authors performed an 11-year retrospective review of all infants with Robin sequence treated at a neonatal intensive care unit. Patient characteristics were correlated to mortality and quality-of-life measures. Emergency room visits and hospital admissions were used to assess quality-of-life outcomes. Significant variables were identified by means of univariate analysis. Results: One hundred eighty-one consecutive infants were identified. Patient characteristics included the following: isolated, 32.6 percent; syndromic, 31.5 percent; gastrointestinal, 38.1 percent; pulmonary, 32.6 percent; cardiac, 30.9 percent; central nervous system, 25.4 percent; and two or more organ system anomalies, 69.6 percent. Mortality was 16.6 percent; two deaths were related to airway obstruction problems. There were no deaths in isolated Robin sequence (p = 0.002). Mortality was statistically associated with cardiac anomalies (p <0.001), central nervous system anomalies (p = 0.001), and two or more organ system abnormalities (p = 0.001). Variables associated with an increased rate of emergency room visits were cardiac anomalies (p = 0.04) and two or more organ system abnormalities (p = 0.04). The presence of two or more organ system abnormalities (p = 0.04) was associated with an increased hospital admission rate. Conclusions: Mortality and negative quality-of-life measures in Robin sequence are not directly related to respiratory obstruction. Isolated Robin sequence confers no increased risk of mortality. There is a high incidence of cardiac and central nervous system anomalies, which are significantly associated with mortality. Cardiac and cranial imaging should be performed during the initial evaluation of infants with Robin sequence.

Original languageEnglish (US)
Pages (from-to)738-745
Number of pages8
JournalPlastic and Reconstructive Surgery
Volume134
Issue number4
DOIs
StatePublished - 2014
Externally publishedYes

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Pierre Robin Syndrome
Cause of Death
Mortality
Nervous System Malformations
Central Nervous System
Quality of Life
Hospital Emergency Service
Neonatal Intensive Care Units
Infant Mortality
Airway Obstruction
Lung
Incidence

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Costa, M. A., Tu, M. M., Murage, K. P., Tholpady, S. S., Engle, W. A., & Flores, R. L. (2014). Robin sequence: Mortality, causes of death, and clinical outcomes. Plastic and Reconstructive Surgery, 134(4), 738-745. https://doi.org/10.1097/PRS.0000000000000510

Robin sequence : Mortality, causes of death, and clinical outcomes. / Costa, Melinda A.; Tu, Michael M.; Murage, Kariuki P.; Tholpady, Sunil S.; Engle, William A.; Flores, Roberto L.

In: Plastic and Reconstructive Surgery, Vol. 134, No. 4, 2014, p. 738-745.

Research output: Contribution to journalArticle

Costa, MA, Tu, MM, Murage, KP, Tholpady, SS, Engle, WA & Flores, RL 2014, 'Robin sequence: Mortality, causes of death, and clinical outcomes', Plastic and Reconstructive Surgery, vol. 134, no. 4, pp. 738-745. https://doi.org/10.1097/PRS.0000000000000510
Costa, Melinda A. ; Tu, Michael M. ; Murage, Kariuki P. ; Tholpady, Sunil S. ; Engle, William A. ; Flores, Roberto L. / Robin sequence : Mortality, causes of death, and clinical outcomes. In: Plastic and Reconstructive Surgery. 2014 ; Vol. 134, No. 4. pp. 738-745.
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AU - Engle, William A.

AU - Flores, Roberto L.

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N2 - Background: The authors report the cause of and risk factors for mortality in infants with Robin sequence and identify characteristics associated with qualityof- life outcomes. Methods: The authors performed an 11-year retrospective review of all infants with Robin sequence treated at a neonatal intensive care unit. Patient characteristics were correlated to mortality and quality-of-life measures. Emergency room visits and hospital admissions were used to assess quality-of-life outcomes. Significant variables were identified by means of univariate analysis. Results: One hundred eighty-one consecutive infants were identified. Patient characteristics included the following: isolated, 32.6 percent; syndromic, 31.5 percent; gastrointestinal, 38.1 percent; pulmonary, 32.6 percent; cardiac, 30.9 percent; central nervous system, 25.4 percent; and two or more organ system anomalies, 69.6 percent. Mortality was 16.6 percent; two deaths were related to airway obstruction problems. There were no deaths in isolated Robin sequence (p = 0.002). Mortality was statistically associated with cardiac anomalies (p <0.001), central nervous system anomalies (p = 0.001), and two or more organ system abnormalities (p = 0.001). Variables associated with an increased rate of emergency room visits were cardiac anomalies (p = 0.04) and two or more organ system abnormalities (p = 0.04). The presence of two or more organ system abnormalities (p = 0.04) was associated with an increased hospital admission rate. Conclusions: Mortality and negative quality-of-life measures in Robin sequence are not directly related to respiratory obstruction. Isolated Robin sequence confers no increased risk of mortality. There is a high incidence of cardiac and central nervous system anomalies, which are significantly associated with mortality. Cardiac and cranial imaging should be performed during the initial evaluation of infants with Robin sequence.

AB - Background: The authors report the cause of and risk factors for mortality in infants with Robin sequence and identify characteristics associated with qualityof- life outcomes. Methods: The authors performed an 11-year retrospective review of all infants with Robin sequence treated at a neonatal intensive care unit. Patient characteristics were correlated to mortality and quality-of-life measures. Emergency room visits and hospital admissions were used to assess quality-of-life outcomes. Significant variables were identified by means of univariate analysis. Results: One hundred eighty-one consecutive infants were identified. Patient characteristics included the following: isolated, 32.6 percent; syndromic, 31.5 percent; gastrointestinal, 38.1 percent; pulmonary, 32.6 percent; cardiac, 30.9 percent; central nervous system, 25.4 percent; and two or more organ system anomalies, 69.6 percent. Mortality was 16.6 percent; two deaths were related to airway obstruction problems. There were no deaths in isolated Robin sequence (p = 0.002). Mortality was statistically associated with cardiac anomalies (p <0.001), central nervous system anomalies (p = 0.001), and two or more organ system abnormalities (p = 0.001). Variables associated with an increased rate of emergency room visits were cardiac anomalies (p = 0.04) and two or more organ system abnormalities (p = 0.04). The presence of two or more organ system abnormalities (p = 0.04) was associated with an increased hospital admission rate. Conclusions: Mortality and negative quality-of-life measures in Robin sequence are not directly related to respiratory obstruction. Isolated Robin sequence confers no increased risk of mortality. There is a high incidence of cardiac and central nervous system anomalies, which are significantly associated with mortality. Cardiac and cranial imaging should be performed during the initial evaluation of infants with Robin sequence.

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