Short‑ and long‑term prognostic factors of non‑neoplastic esophageal fistula: a retrospective study of 100 patients.

PURPOSE: This study examines the effects of different treatments on the prognosis of non-malignant esophageal fistula, a rare but serious condition, and identifies factors affecting post-fistula survival and healing.

METHODS

This study retrospectively analyzed clinical data of patients with non-malignant esophageal fistula, categorizing them into conservative, endoscopic, and surgical groups. It compared Clinical Pulmonary Infection Score (CPIS) gap, hospital stay length, ICU admission, 30-day readmission, in-hospital and 90-day mortality rates, and hospitalization costs among these groups, while also assessing factors influencing post-fistula survival and healing.

RESULTS

100 patients were included. Those who had surgery experienced longer hospital stays (P < 0.001), higher ICU occupancy rates (P = 0.006), and increased costs (P = 0.001) compared to others. Patients treated conservatively had a higher 30-day readmission rate (P = 0.018). Post-fistula survival and healing were unaffected by the primary treatment approach. Multivariate Cox regression indicated that smaller fistulas (P = 0.048), nasojejunal tube (P = 0.045), and thoracic drainage tube (P = 0.035) were favorable factors for fistula healing, while a lower BMI (P = 0.026) negatively impacted post-fistula survival.

CONCLUSION

Endoscopic treatment showed better short-term outcomes than the other groups, though it didn’t significantly improve post-fistula survival and healing. Several factors significantly impact the prognosis of esophageal fistula patients, requiring careful consideration in clinical practice.