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J Pediatr. 2002 Jul;141(1):25-30.

Influence of congenital heart disease on survival in children with congenital diaphragmatic hernia.

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1
Cardiac Center and The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.

Abstract

OBJECTIVE:

We sought to assess outcome in patients with CDH and HD to determine if LHR is also predictive of outcome in this subset of patients.

STUDY DESIGN:

We carried out a retrospective review (April 1996-October 2000) of patients with isolated CDH (n = 143, 82.2%) and patients with HD (n = 31, 17.8%) to determine the incidence of additional anomalies, survival to term, CDH repair, cardiac repair, and survival to discharge. Survival based on LHR was analyzed in a subset of fetuses.

RESULTS:

The risk of death from birth to last follow-up was 2.9 times higher for patients with CDH plus HD than for patients with CDH alone (P <.0001). Of 11 patients with CDH plus HD who had CDH repair (5 of whom also had HD repair), 5 survived. All 10 patients with an LHR <1.2 died; 3 of 6 with an LHR >1.2 survived (Fisher exact test, P =.04).

CONCLUSION:

Heart disease remains a significant risk factor for death in infants with CDH. The LHR helps predict survival in this high-risk group of patients.

PMID:
12091847
DOI:
10.1067/mpd.2002.125004
[Indexed for MEDLINE]
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