Risk factors associated with death of newborn with congenital diaphragmatic hernia / 中国小儿急救医学

ABSTRACT

Objective To investigate the risk factors of congenital diaphragmatic hernia (CDH) deaths.Methods A retrospective study was conducted on 37 CDH patients during 10 years.Clinical characteristics and risk factors were compared and non-conditional logistic regression analysis was performed to determine independent predictors for mortality.Results Twenty nine patients,from a total of 37,underwent surgery for CDH.The total mortality rate in patients with CDH was 32.4％ (12/37) and the overall operative mortality was 13.8％ (4/29).There was a significant difference between CDH patients who survived (n =25) and those who died (n =12) in birth weight[(3.12±0.41) kg vs (2.66 ±0.65) kg],the age on admission [(135.14 ± 209.71) h vs (6.67 ± 7.79) h],hospital length of stay [(16.52 ± 6.23) d vs (1.25 ±1.38) d],oxygenation index[(239.55 ± 115.95) mmHg vs (96.10 ±59.18) mmHg,1 mmHg =0.133 kPa],early antenatal diagnosis (3 cases vs 6 cases),right congenital diaphragmatic hernia(1 cases vs 4 cases),cardiac malformations (2 cases vs 6 cases) and presence of persistent pulmonary hypertension of newborn (3 cases vs 7 cases) (P ＜0.05).Using logistic regression analysis,the following factors independently predicted mortality were antenatal diagnosis (OR =20.97,95％ CI 1.60 ～ 275.78),low oxygenation index (OR =18.12,95 ％ CI 0.80 ～ 123.12) and cardiac malformations (OR =22.0,95 ％ CI 1.46 ～ 332.32).Conclusion CDH patients have higher mortality.Risk factors for mortality in neonatal CDH are associated with early antenatal diagnosis,low oxygenation index and cardiac malformations.