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World Journal of Surgery

, Volume 43, Issue 1, pp 282–290 | Cite as

Predicting Survival of Congenital Diaphragmatic Hernia on the First Day of Life

  • Chaeyoun Oh
  • Joong Kee Youn
  • Ji-Won Han
  • Hee-Byum Yang
  • Sanghoon Lee
  • Jeong-Meen Seo
  • In Geol Ho
  • Soo-Hong Kim
  • Yong Hoon Cho
  • Seung Han Shin
  • Hyun-Young Kim
  • Sung-Eun Jung
Original Scientific Report

Abstract

Background

This study aimed to determine perinatal risk factors for 30-day mortality of congenital diaphragmatic hernia (CDH) patients and develop a prognostic index to predict 30-day mortality of CDH patients. Identifying risk factors that can prognosticate outcome is critical to obtain the best management practices for patients.

Methods

A retrospective study was performed for patients who were diagnosed with CDH from November 2000 to August 2016. A total of 10 prenatal risk factors and 14 postnatal risk factors were analyzed. All postnatal variables were measured within 24 h after birth.

Results

A total of 95 CDH patients were enrolled in this study, including 61 males and 34 females with mean gestational age of 38.86 ± 1.51 weeks. The overall 30-day survival rate was 63.2%. Multivariate analysis revealed that five factors (polyhydramnios, gestational age at diagnosis <25 weeks, observed-to-expected lung-to-head ratio ≤45, best oxygenation index in 24 h  >11, and severity of tricuspid regurgitation ≥ mild) were independent predictors of 30-day mortality of CDH. Using these five factors, a perinatal prognostic index for 30-day mortality was developed. Four predictive models (poor, bad, good, and excellent) of the perinatal prognostic index were constructed, and external validation was performed.

Conclusions

Awareness of risk factors is very important for predicting prognosis and managing patients. Five independent perinatal risk factors were identified in this study. A perinatal prognostic index was developed for 30-day mortality for patients with CDH. This index may be used to help manage CDH patients.

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Chaeyoun Oh
    • 1
  • Joong Kee Youn
    • 2
  • Ji-Won Han
    • 2
  • Hee-Byum Yang
    • 2
  • Sanghoon Lee
    • 3
  • Jeong-Meen Seo
    • 3
  • In Geol Ho
    • 4
  • Soo-Hong Kim
    • 5
  • Yong Hoon Cho
    • 5
  • Seung Han Shin
    • 6
  • Hyun-Young Kim
    • 2
  • Sung-Eun Jung
    • 2
  1. 1.Department of Pediatric SurgeryKorea University College of MedicineSeoulKorea
  2. 2.Department of Pediatric Surgery, Seoul National University College of MedicineChildren’s HospitalSeoulKorea
  3. 3.Department of Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  4. 4.Department of Pediatric Surgery, Severance Children’s HospitalYonsei University College of MedicineSeoulKorea
  5. 5.Department of Pediatric SurgeryPusan National University Children’s HospitalYangsanKorea
  6. 6.Department of PediatricsSeoul National University College of MedicineSeoulKorea

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