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Research: Predictors of Mortality among Neonates with Congenital Diaphragmatic Hernia: Experience from an Inborn Unselected Cohort in India.

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Research: Predictors of Mortality among Neonates with Congenital Diaphragmatic Hernia: Experience from an Inborn Unselected Cohort in India.

Indian Pediatr. 2019 Dec 15;56(12):1037-1040. https://www.ncbi.nlm.nih.gov/pubmed/31884435

Predictors of Mortality among Neonates with Congenital Diaphragmatic Hernia: Experience from an Inborn Unselected Cohort in India.

Sahoo T1Sivanandan S1Thomas D1Verma A1Thukral A2Sankar MJ1Agarwal R1Deorari AK1.

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Abstract

OBJECTIVE:

To evaluate the clinical profile and predictors of mortality in neonates with congenital diaphragmatic hernia (CDH).

METHODS:

Demographic and clinical parameters of neonates with congenital diaphragmatic heria (n=37) between January 2014 and October, 2017 were reviewed, and compared among those who survived or expired in hospital.

RESULTS:

Median (range) gestation and birthweight were 38 (37-39) weeks and 2496 (2044-2889) g, respectively. Persistent pulmonary hypertension (PPHN) was documented in 19 (51%) neonates and 10 (27%) had associated malformations. Surgery could be performed in 18 (49%), overall mortality was 60%. On univariate analysis, low Apgar scores, presence of malformations, PPHN, need for higher initial peak inspiratory pressure/high frequency ventilation, and requirement of a patch for closure were associated with increased mortality. On multivariate analysis, PPHN remained the only significant risk factor [adjusted RR 3.74 (95% CI 1.45-9.68)].

CONCLUSIONS:

The survival of infants with CDH is low, and PPHN is an important predictor of mortality.PMID: 31884435

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