One-year survival in congenital diaphragmatic hernia, 1995-2006

Survival disparities in newborns with congenital diaphragmatic hernia: a national perspective

“…This finding lends further support that reports of increased survival for CDH may be because of selection of patients who are stable for transfer and eventual surgical repair. Our survival rate of 66% for a nationwide sample is significantly lower than the 82% to 93% survival reported from single tertiary care centers [11][12][13][14][15][16] revealing that a hidden mortality for CDH exists in the United States. In contrast to other studies, however, we found no difference in survival for hospitals with the highest surgical case volumes [11,14].…”

“…Recent studies from single tertiary care centers have reported improved survival ranging from 82% to 93% with management strategies emphasizing inhaled nitric oxide, permissive hypercapnea, high frequency oscillatory ventilation, selective use of extracorporeal membrane oxygenation (ECMO), delayed surgical repair, and treatment at high volume centers [11][12][13][14][15][16]. In contrast, current population-based studies from the United Kingdom and Australia report significantly lower survival (54%-56%) of live-born infants despite new therapies for CDH [4,17,18].…”

Predictors of neonatal morbidity in fetuses with severe isolated congenital diaphragmatic hernia undergoing fetoscopic tracheal occlusion

“…Survivors were operated on at a median age of 2.0 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] days; 77% of them required a patch augmented repair. Full enteral feeding was possible at 26 (range, 5-150) days of age.…”

Predictors of Mortality and Morbidity in Infants with CDH

“…It is associated with significant mortality and morbidity (Abdullah et al, 2009). Survival data for CDH are conflicting; a few centers reported 82% to 93% survival rate (Javid et al, 2004;Grushka et al, 2009;Mettauer et al, 2009) while others had significantly less figures (54%-56%) (Colvin et al, 2005;Levison et al, 2006). This divergence in survival data has been attributed to case selection bias at single tertiary care institutions because as many as 35% of live-born infants with CDH do not survive to transport resulting in a hidden mortality for this condition (Harrison et al, 1978;Colvin et al;, V.K.…”