Document Detail


Mortality in infants with congenital diaphragmatic hernia: a study of the United States National Database.
MedLine Citation:
PMID:  20147959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the effect of regionalization of care on outcomes of neonates with congenital diaphragmatic hernia (CDH). Study Design: We analyzed the National Inpatient Sample and the 'Kids' database for the years 1997 to 2004. Infants with CDH were grouped based on whether they underwent surgical repair at the hospital of birth, or at another facility. Groups were compared using chi-square, t-test and logistic regression.
RESULT: A total of 2140 infants were included: 41% were females, 42% were Caucasians, 48% were transported, 20% reported the use of extracorporeal membrane oxygenation (ECMO)and 33% died. Only 79% underwent operative repair, in which 85% survived after surgery. Survival among operated patients who used ECMO was 40%. Transported infants used more ECMO than non-transported ones (25 vs 15%; adjusted odds ratio (OR) 1.46; confidence interval 1.1 to 1.9, P=0.007), and had higher mortality after surgery (16 vs 13%; adjusted OR 1.46; confidence interval 1.1 to 2, P=0.02).
CONCLUSION: The utilization of neonatal transport of CDH patients is associated with increased mortality and increased need for ECMO. This study supports the need for regionalization of care, and favors maternal transport before delivery of CDH newborns.
Authors:
H Aly; D Bianco-Batlles; M A Mohamed; T A Hammad
Related Documents :
8046649 - The reproducibility of the response of the human newborn to co2 measured by rebreathing...
8482289 - Determinants of oxygenation during high frequency oscillation.
15748969 - Management of infants with chronic lung disease of prematurity in china.
18450889 - Achievement of targeted saturation values in extremely low gestational age neonates res...
9797629 - Arterial oxygen saturation profiles in healthy preterm infants.
14530859 - Intravenous sildenafil and inhaled nitric oxide: a randomised trial in infants after ca...
11332779 - Discordant and nondiscordant twins: comparative multimethod risk assessment in the neon...
19172129 - Galacto-oligosaccharides are bifidogenic and safe at weaning: a double-blind randomized...
16456659 - The immediate and long-term outcomes of newborns with congenital diaphragmatic hernia.
Publication Detail:
Type:  Journal Article     Date:  2010-02-11
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  30     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-29     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  553-7     Citation Subset:  IM    
Affiliation:
Department of Neonatology, George Washington University and Children's National Medical Center, Washington, DC 20037, USA. haly@mfa.gwu.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Extracorporeal Membrane Oxygenation / mortality,  utilization*
Female
Hernia, Diaphragmatic / congenital*,  mortality*,  therapy
Humans
Infant, Newborn
Male
Patient Transfer / statistics & numerical data*
Registries
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Determinants of erectile dysfunction in type 2 diabetes.
Next Document:  Predictors of survival in congenital diaphragmatic hernia patients requiring extracorporeal membrane...