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RESEARCH: “Aggressive Surgical Management of Congenital Diaphragmatic Hernia: Worth the Effort? A Multicenter, Prospective, Cohort Study”

RESEARCH: “Aggressive Surgical Management of Congenital Diaphragmatic Hernia: Worth the Effort? A Multicenter, Prospective, Cohort Study”

Objective: The objectives of this study were (i) to evaluate infants with congenital diaphragmatic hernia (CDH) that do not undergo repair, (ii) to identify nonrepair rate by institution, and (iii) to compare institutional outcomesbased on nonrepair rate.

Background: Approximately 20% of infants with CDH go unrepaired and the threshold to offer surgical repair is variable.

Methods: Data were abstracted from a multicenter, prospectively collected database. Standard clinical variables, including repair (or nonrepair), and outcome were analyzed. Institutions were grouped based on volume and rate of nonrepair. Preoperative mortality predictors were identified using logistic regression, expected mortality for each center was calculated, and observed /expected (O/E) ratios were computed for center groups and compared by Kruskal-Wallis ANOVA.

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