Risk factors of death in newborns with congenital diaphragmatic hernia.
- Author:
Dong CHEN
1
;
Yuanjun HU
2
;
Yurui WU
3
;
Xiaoying LI
1
Author Information
1. Neonatal Intensive Care Unit, Qilu Children's Hospital of Shandong University, Jinan 250022, China.
2. Department of Neonate Surgery, Qilu Children's Hospital of Shandong University, Jinan 250022, China.
3. Department of Thoracic and Oncological Surgery(Department of Minimally Invasive Surgery), Qilu Children's Hospital of Shandong University, Jinan 250022, China.
- Publication Type:Journal Article
- MeSH:
Hernias, Diaphragmatic, Congenital;
diagnosis;
mortality;
surgery;
Humans;
Infant;
Infant Death;
Infant, Newborn;
Logistic Models;
ROC Curve;
Retrospective Studies;
Risk Factors;
Sensitivity and Specificity
- From:
Journal of Zhejiang University. Medical sciences
2019;48(1):83-88
- CountryChina
- Language:Chinese
-
Abstract:
To investigate risk factors of death in newborns with congenital diaphragmatic hernia (CDH). A total of 126 newborns with CDH from June 2012 to September 2018 were enrolled. Concomitant malformations were recorded by descriptive analysis. Newborns received surgical treatment (=120) for CDH were divided into survival group and fatal group. The risk factors of death were analyzed by univariate and multivariate logistic regression and the ROC curve with generated with relevant variables. There were 55 CDH newborns with concomitant malformations (43.7%), including 20 cases (15.9%) with multi-malformation. Logistic regression analysis showed that premature rupture of membranes (PROM), postoperative atelectasis, long duration of postoperative mechanical ventilation, postoperative high oxygenation index (OI) were related to death (all <0.05), and the delayed surgery was a protective factor (<0.05). In ROC analysis of postoperative OI in predicting death, the area under the curve (AUC) was 0.841, with the cutoff value of 5.74, the sensibility and specificity of OI was 81.0% and 75.0%, respectively(<0.01). Newborns with CDH have a high rate of malformations. The risk factors of death were PROM, postoperative atelectasis, postoperative long duration of mechanical ventilation and higher postoperative OI, and delayed surgery may reduce mortality.
