Outcomes of congenital diaphragmatic hernia in the modern era of management

Julia Wynn, Usha Krishnan, Gudrun Aspelund, Yuan Zhang, Jimmy Duong, Charles J H Stolar, Eunice Hahn, John Pietsch, Dai Chung, Donald Moore, Eric Austin, George Mychaliska, Robert Gajarski, Yen Lim Foong, Erik Michelfelder, Douglas Potolka, Brian Bucher, Brad Warner, Mark Grady, Kenneth Azarow & 7 others Scott E. Fletcher, Shelby Kutty, Jeff Delaney, Timothy Crombleholme, Erika Rosenzweig, Wendy Chung, Marc S. Arkovitz

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Objective: To identify clinical factors associated with pulmonary hypertension (PH) and mortality in patients with congenital diaphragmatic hernia (CDH). Study design: A prospective cohort of neonates with a diaphragm defect identified at 1 of 7 collaborating medical centers was studied. Echocardiograms were performed at 1 month and 3 months of age and analyzed at a central core by 2 cardiologists independently. Degree of PH and survival were tested for association with clinical variables using Fischer exact test, χ2, and regression analysis. Results: Two hundred twenty patients met inclusion criteria. Worse PH measured at 1 month of life was associated with higher mortality. Other factors associated with mortality were need for extracorporeal membrane oxygenation, patients inborn at the treating center, and patients with a prenatal diagnosis of CDH. Interestingly, patients with right sided CDH did not have worse outcomes. Conclusions: Severity of PH is associated with mortality in CDH. Other factors associated with mortality were birth weight, gestational age at birth, inborn status, and need for extracorporeal membrane oxygenation.

Original languageEnglish (US)
JournalJournal of Pediatrics
Volume163
Issue number1
DOIs
StatePublished - 2013
Externally publishedYes

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Pulmonary Hypertension
Mortality
Extracorporeal Membrane Oxygenation
Patient Rights
Diaphragm
Prenatal Diagnosis
Birth Weight
Gestational Age
Regression Analysis
Congenital Diaphragmatic Hernias
Parturition
Newborn Infant
Survival

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Wynn, J., Krishnan, U., Aspelund, G., Zhang, Y., Duong, J., Stolar, C. J. H., ... Arkovitz, M. S. (2013). Outcomes of congenital diaphragmatic hernia in the modern era of management. Journal of Pediatrics, 163(1). https://doi.org/10.1016/j.jpeds.2012.12.036

Outcomes of congenital diaphragmatic hernia in the modern era of management. / Wynn, Julia; Krishnan, Usha; Aspelund, Gudrun; Zhang, Yuan; Duong, Jimmy; Stolar, Charles J H; Hahn, Eunice; Pietsch, John; Chung, Dai; Moore, Donald; Austin, Eric; Mychaliska, George; Gajarski, Robert; Foong, Yen Lim; Michelfelder, Erik; Potolka, Douglas; Bucher, Brian; Warner, Brad; Grady, Mark; Azarow, Kenneth; Fletcher, Scott E.; Kutty, Shelby; Delaney, Jeff; Crombleholme, Timothy; Rosenzweig, Erika; Chung, Wendy; Arkovitz, Marc S.

In: Journal of Pediatrics, Vol. 163, No. 1, 2013.

Research output: Contribution to journalArticle

Wynn, J, Krishnan, U, Aspelund, G, Zhang, Y, Duong, J, Stolar, CJH, Hahn, E, Pietsch, J, Chung, D, Moore, D, Austin, E, Mychaliska, G, Gajarski, R, Foong, YL, Michelfelder, E, Potolka, D, Bucher, B, Warner, B, Grady, M, Azarow, K, Fletcher, SE, Kutty, S, Delaney, J, Crombleholme, T, Rosenzweig, E, Chung, W & Arkovitz, MS 2013, 'Outcomes of congenital diaphragmatic hernia in the modern era of management', Journal of Pediatrics, vol. 163, no. 1. https://doi.org/10.1016/j.jpeds.2012.12.036
Wynn, Julia ; Krishnan, Usha ; Aspelund, Gudrun ; Zhang, Yuan ; Duong, Jimmy ; Stolar, Charles J H ; Hahn, Eunice ; Pietsch, John ; Chung, Dai ; Moore, Donald ; Austin, Eric ; Mychaliska, George ; Gajarski, Robert ; Foong, Yen Lim ; Michelfelder, Erik ; Potolka, Douglas ; Bucher, Brian ; Warner, Brad ; Grady, Mark ; Azarow, Kenneth ; Fletcher, Scott E. ; Kutty, Shelby ; Delaney, Jeff ; Crombleholme, Timothy ; Rosenzweig, Erika ; Chung, Wendy ; Arkovitz, Marc S. / Outcomes of congenital diaphragmatic hernia in the modern era of management. In: Journal of Pediatrics. 2013 ; Vol. 163, No. 1.
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abstract = "Objective: To identify clinical factors associated with pulmonary hypertension (PH) and mortality in patients with congenital diaphragmatic hernia (CDH). Study design: A prospective cohort of neonates with a diaphragm defect identified at 1 of 7 collaborating medical centers was studied. Echocardiograms were performed at 1 month and 3 months of age and analyzed at a central core by 2 cardiologists independently. Degree of PH and survival were tested for association with clinical variables using Fischer exact test, χ2, and regression analysis. Results: Two hundred twenty patients met inclusion criteria. Worse PH measured at 1 month of life was associated with higher mortality. Other factors associated with mortality were need for extracorporeal membrane oxygenation, patients inborn at the treating center, and patients with a prenatal diagnosis of CDH. Interestingly, patients with right sided CDH did not have worse outcomes. Conclusions: Severity of PH is associated with mortality in CDH. Other factors associated with mortality were birth weight, gestational age at birth, inborn status, and need for extracorporeal membrane oxygenation.",
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AU - Krishnan, Usha

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AU - Stolar, Charles J H

AU - Hahn, Eunice

AU - Pietsch, John

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AU - Grady, Mark

AU - Azarow, Kenneth

AU - Fletcher, Scott E.

AU - Kutty, Shelby

AU - Delaney, Jeff

AU - Crombleholme, Timothy

AU - Rosenzweig, Erika

AU - Chung, Wendy

AU - Arkovitz, Marc S.

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N2 - Objective: To identify clinical factors associated with pulmonary hypertension (PH) and mortality in patients with congenital diaphragmatic hernia (CDH). Study design: A prospective cohort of neonates with a diaphragm defect identified at 1 of 7 collaborating medical centers was studied. Echocardiograms were performed at 1 month and 3 months of age and analyzed at a central core by 2 cardiologists independently. Degree of PH and survival were tested for association with clinical variables using Fischer exact test, χ2, and regression analysis. Results: Two hundred twenty patients met inclusion criteria. Worse PH measured at 1 month of life was associated with higher mortality. Other factors associated with mortality were need for extracorporeal membrane oxygenation, patients inborn at the treating center, and patients with a prenatal diagnosis of CDH. Interestingly, patients with right sided CDH did not have worse outcomes. Conclusions: Severity of PH is associated with mortality in CDH. Other factors associated with mortality were birth weight, gestational age at birth, inborn status, and need for extracorporeal membrane oxygenation.

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