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    
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.
H Aly; D Bianco-Batlles; M A Mohamed; T A Hammad
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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:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  553-7     Citation Subset:  IM    
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MeSH Terms
Extracorporeal Membrane Oxygenation / mortality,  utilization*
Hernia, Diaphragmatic / congenital*,  mortality*,  therapy
Infant, Newborn
Patient Transfer / statistics & numerical data*
United States / epidemiology

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