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Risk stratification for congenital diaphragmatic hernia by factors within 24 h after birth.
Terui, K; Nagata, K; Kanamori, Y; Takahashi, S; Hayakawa, M; Okuyama, H; Inamura, N; Yoshida, H; Taguchi, T; Usui, N.
Affiliation
  • Terui K; Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Nagata K; Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Kanamori Y; Division of Surgery, National Center for Child Health and Development, Tokyo, Japan.
  • Takahashi S; Department of Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
  • Hayakawa M; Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
  • Okuyama H; Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
  • Inamura N; Department of Pediatrics, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan.
  • Yoshida H; Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Taguchi T; Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Usui N; Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan.
J Perinatol ; 37(7): 805-808, 2017 07.
Article in En | MEDLINE | ID: mdl-28230834
ABSTRACT

OBJECTIVE:

To establish a simple risk stratification system for patients with congenital diaphragmatic hernia (CDH) based on postnatal information within 24 h after birth. STUDY

DESIGN:

A multi-institutional retrospective cohort study was conducted including 348 neonates who had isolated CDH born between 2006 and 2010. Based on the two most powerful variables for 90-day survival selected by multivariate analyses, a risk stratification system was established.

RESULTS:

Multiple logistic regression analysis identified two adverse prognostic factors an Apgar score at 1 min (Ap1) of 0-4 (odds ratio (OR) 3.3, P=0.004), and a best oxygenation index (OI) ⩾8.0 (OR 11.4, P<0.001). Based on a combinations of these two factors, patients were classified into three risk categories. The 90-day survival rates in categories 1-3 were 100, 88 and 52%, respectively (P<0.001).

CONCLUSION:

Our simple risk stratification system based on Ap1 and best OI was capable of predicting mortality well.
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Full text: 1 Database: MEDLINE Main subject: Hernias, Diaphragmatic, Congenital Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Female / Humans / Male / Newborn Country/Region as subject: Asia Language: En Year: 2017 Type: Article
Fulltext
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Full text: 1 Database: MEDLINE Main subject: Hernias, Diaphragmatic, Congenital Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Female / Humans / Male / Newborn Country/Region as subject: Asia Language: En Year: 2017 Type: Article