Predicting death or extended length of stay in infants with congenital diaphragmatic hernia

Murthy, Karna; Pallotto, Eugenia K.; Gien, Jason; Brozanski, Beverly; Porta, Nicolas F M; Zaniletti, Isabella; Keene, Sarah; Chicoine, Louis G.; Rintoul, Natalie E.; Dykes, Francine D.; Asselin, Jeanette M.; Short, Billie Lou; Padula, Michael A.; Durand, David J.; Reber, Kristina M.; Evans, Jacquelyn R.; Grover, Theresa R.

doi:10.1038/jp.2016.26

Cited by 32 publications

(8 citation statements)

References 19 publications

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“…About one-third of infants with CDH require extracorporeal life support (ECLS), representing the most severe lesions [ 3 ]. While the overall survival rate for isolated CDH ranges from 50–80%, infants requiring ECLS have worse survival rates, with almost six times increased odds of mortality [ 2 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for acute kidney injury in neonates with congenital diaphragmatic hernia

et al. 2021

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Objective To examine incidence of acute kidney injury (AKI), antenatal and postnatal predictors, and impact of AKI on outcomes in infants with congenital diaphragmatic hernia (CDH). Study design Single center retrospective study of 90 CDH infants from 2009–2017. Baseline characteristics, CDH severity, possible AKI predictors, and clinical outcomes were compared between infants with and without AKI. Result In total, 38% of infants developed AKI, 44% stage 1, 29% stage 2, 27% stage 3. Lower antenatal lung volumes and liver herniation were associated with AKI. Extracorporeal life support (ECLS), diuretics, abdominal closure surgery, hypotension, and elevated plasma free hemoglobin were associated with AKI. Overall survival was 79%, 47% with AKI, and 35% with AKI on ECLS. AKI is associated with increased mechanical ventilation duration and length of stay. Conclusion AKI is common among CDH infants and associated with adverse outcomes. Standardized care bundles addressing AKI risk factors may reduce AKI incidence and severity.

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Section: Introductionmentioning

confidence: 99%

Risk factors for acute kidney injury in neonates with congenital diaphragmatic hernia

et al. 2021

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“…Congenital diaphragmatic hernia (CDH) occurs in~1 in 3000 live births and has a mortality rate between 20-40% [1][2][3][4]. Prenatal predictors of survival, based on ultrasound and magnetic resonance imaging findings [5,6], can aid in prenatal counselling of families regarding survival and prognosis.…”

Section: Introductionmentioning

confidence: 99%

Comparison of early postnatal prediction models for survival in congenital diaphragmatic hernia

2019

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Objective To compare the PF-PCO 2 equation-partial pressure of arterial oxygen (PaO 2)/fraction of inspired oxygen (FiO 2) minus partial pressure of carbon dioxide (PCO 2)-to three other tools for postnatal prediction of survival in infants with congenital diaphragmatic hernia (CDH). Study design A retrospective analysis of 203 infants with CDH from 1 January 2003 to 30 June 2018. Area under the curve (AUC) analysis was performed for survival and secondary outcomes of survival without extracorporeal membrane oxygenation support (ECMO) and death despite ECMO. Predictive scores were calculated to determine cutoff for PF-PCO 2 score. Results The PF-PCO 2 tool had the highest AUC (0.84 for survival, 0.92 for survival without ECMO, and 0.83 for death despite ECMO). PF-PCO 2 best predicted survival when >−60 and survival without ECMO when >+80. There was no optimal cutoff score for death despite ECMO. Conclusion The PF-PCO 2 tool best predicted postnatal survival in infants with CDH.

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“…[13,14] A previously published study shows that a diagnosed BSI is one factor that predicts mortality or prolonged length of stay. [15] In this study, the incidence of nosocomial infection, length of stay and total medical expenses of hospitalized patients in the STG were signi cantly higher than those of patients in the NTG; further analysis found that the total intubation time, length of stay and cost of children with nosocomial infection were higher than those in the nosocomial infection-free group. It was shown that the occurrence of nosocomial infection is associated with prolonged hospital stay.…”

Section: Discussionmentioning

confidence: 47%

Impact of the COVID-19 pandemic on congenital diaphragmatic hernia patients: a single-center retrospective study

Zhao

Wang

Liu

et al. 2022

Preprint

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Purpose To investigate the impact of COVID-19 on the treatment of children with congenital diaphragmatic hernia (CDH).Methods We retrospectively collected and compared the data of patients with CDH admitted between January 1, 2020 and December 31, 2021 with the CDH patients admitted before the pandemic between January 1, 2018 and December 31, 2019 (control group).Results During the pandemic, 41 patients with CDH diagnosed prenatally were transferred to our hospital, and 40 underwent surgical repair. The number of patients treated in our hospital increased by 24.2% compared with that before the pandemic. During the pandemic, the overall survival rate, postoperative survival rate and recurrence rate were 85.4%, 87.5% and 7.3%, respectively, and there were no significant differences compared with the control group. The average length of hospital stay in patients admitted during the pandemic was longer than that in the control group, and the incidence of nosocomial infection was higher than that in the control group.Conclusions CDH patients confirmed to be SARS-CoV-2 infection-free can receive routine treatment. Our data indicate that the implementation of protective measures during the COVID-19 pandemic, along with appropriate screening and case evaluation, do not have a negative impact on the prognosis of children.

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Predicting death or extended length of stay in infants with congenital diaphragmatic hernia

Abstract: Six variables predicted death or LOS ⩾109 days in this large, contemporary cohort with CDH. These results can assist in risk adjustment for comparative benchmarking and for counseling affected families.

Cited by 32 publications

References 19 publications

Risk factors for acute kidney injury in neonates with congenital diaphragmatic hernia

Risk factors for acute kidney injury in neonates with congenital diaphragmatic hernia

Comparison of early postnatal prediction models for survival in congenital diaphragmatic hernia

Impact of the COVID-19 pandemic on congenital diaphragmatic hernia patients: a single-center retrospective study

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