| Standardized reporting for congenital diaphragmatic hernia - An international consensus. | |
MedLine Citation:
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PMID: 24314179 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND/PURPOSE: Congenital diaphragmatic hernia (CDH) remains a significant cause of neonatal death. A wide spectrum of disease severity and treatment strategies makes comparisons challenging. The objective of this study was to create a standardized reporting system for CDH. METHODS: Data were prospectively collected on all live born infants with CDH from 51 centers in 9 countries. Patients who underwent surgical correction had the diaphragmatic defect size graded (A-D) using a standardized system. Other data known to affect outcome were combined to create a usable staging system. The primary outcome was death or hospital discharge. RESULTS: A total of 1,975 infants were evaluated. A total of 326 infants were not repaired, and all died. Of the remaining 1,649, the defect was scored in 1,638 patients. A small defect (A) had a high survival, while a large defect was much worse. Cardiac defects significantly worsened outcome. We grouped patients into 6 categories based on defect size with an isolated A defect as stage I. A major cardiac anomaly (+) placed the patient in the next higher stage. Applying this, patient survival is 99% for stage I, 96% stage II, 78% stage III, 58% stage IV, 39% stage V, and 0% for non-repair. CONCLUSIONS: The size of the diaphragmatic defect and a severe cardiac anomaly are strongly associated with outcome. Standardizing reporting is imperative in determining optimal outcomes and effective therapies for CDH and could serve as a benchmark for prospective trials. |
Authors:
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Kevin P Lally; Robert E Lasky; Pamela A Lally; Pietro Bagolan; Carl F Davis; Bjorn P Frenckner; Ronald M Hirschl; Max R Langham; Terry L Buchmiller; Noriaki Usui; Dick Tibboel; Jay M Wilson; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 48 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2013 Dec |
Date Detail:
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Created Date: 2013-12-09 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 2408-15 Citation Subset: IM |
Copyright Information:
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© 2013. |
Affiliation:
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UT Health Medical School and Children's Memorial Hermann Hospital, Houston, TX, USA. Electronic address: kevin.p.lally@uth.tmc.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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