Is laterality of congenital diaphragmatic hernia a reliable prognostic factor? French national cohort study.
Pinton A1,2, Boubnova J3, Becmeur F4, Kuhn P5,6, Senat MV7,8, Stirnemann J9,10, Capelle V3, Rosenblatt J11, Massardier J12,13, Vaast P14, Gwenaelle LB15,16, Desrumaux A17, Connant L18, Begue L19, Parmentier B20, Perrotin F21,22, Alain D23, Benoist G24,25, Muszynski C26, Scalabre A27, Winer N28,29, Michel JL30, Casagrandre-Magne F31, Jouannic JM32,33, Gallot D34, Mazeau PC35, Sapin E36, Maatouk A37, Saliou AH38, Sentilhes L39, Biquard F40, Mottet N41, Favre R42, Benachi A43,44, Sananès N45,46.
The objective of this study was to assess whether the laterality of CDH was a prognostic factor for neonatal survival.
This was a cohort study using the French national database of the Reference Center for Diaphragmatic Hernias. The principal endpoint was survival after hospitalization in intensive care. We made a comparative study between right CDH and left CDH by univariate and multivariate analysis. Terminations and stillbirths were excluded from analyses of neonatal outcomes.
A total of 506 CDH were include with 67 (13%) right CDH and 439 left CDH (87%). Rate of survival was 49% for right CDH and 74% for left CDH (P < 0.01). Multivariate analysis showed two factors significantly associated with mortality: thoracic herniation of liver (OR 2.27; IC 95% [1.07-4.76]; P = 0,03) and lung-to-head-ratio over under expected (OR 2.99; IC 95% [1.41-6.36]; P < 0.01). Side of CDH was not significantly associated with mortality (OR 1.87; IC 95% [0.61-5.51], P = 0.26).
Rate of right CDH mortality is more important than left CDH. Nevertheless after adjusting for lung-to-head-ratio and thoracic herniation of liver, right CDH does not have a higher risk of mortality than left CDH. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.PMID: 32279384 DOI: 10.1002/pd.5706