Children (Basel)
. 2026 Jan 12;13(1):108.
doi: 10.3390/children13010108. https://pubmed.ncbi.nlm.nih.gov/41597116/
Risk Stratification of Long-Term Mortality in Infants with Congenital Diaphragmatic Hernia Using the National Health Insurance Service (NHIS) Data
Hye Ji Han 1, Min Ji Suh 2, In Young Choi 1, Ji Soo Park 2, Hwan Soo Kim 3, Hyeon-Jong Yang 4, Dong In Suh 2, Eun Lee 5, Kyung Hoon Kim 1 2
Affiliations Expand
- PMID: 41597116
- PMCID: PMC12839643
- DOI: 10.3390/children13010108
Abstract
Background: Congenital diaphragmatic hernia (CDH) is a rare but serious congenital anomaly linked to high mortality rates and significant long-term morbidity. Although numerous prognostic factors for short-term outcomes have been identified through hospital-based studies, data on long-term mortality at the population level are limited. Specifically, nationwide assessments of long-term outcomes for infants with CDH are scarce. This study aimed to estimate the national 5-year all-cause mortality for CDH and to create a population-level risk stratification nomogram utilizing nationwide health insurance claims data. Methods: We conducted a retrospective cohort study of infants with CDH using nationwide insurance claims data from 2002 to 2016, allowing for complete 5-year follow-up. We analyzed population-level demographic and clinical proxy variables with Cox proportional hazards models and developed a nomogram for long-term mortality risk stratification. Results: Factors such as rural residence, middle-to-high SES, respiratory distress in newborns, and CHD were associated with increased 5-year mortality in infants with CDH. The claims-based nomogram, which incorporated sociodemographic and comorbidity variables, demonstrated moderate discriminatory power (AUC 0.76; C-index 0.78) for population-level risk stratification. Conclusions: This nationwide claims-based cohort study provides population-level estimates of 5-year mortality associated with CDH and introduces a nomogram that offers moderate discriminatory ability for long-term risk stratification.
Keywords: congenital diaphragmatic hernia; mortality; population-level risk stratification; survival.
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