TY - JOUR
T1 - Comparative outcomes of right versus left congenital diaphragmatic hernia
T2 - A multicenter analysis
AU - Abramov, Alexey
AU - Fan, Weijia
AU - Hernan, Rebecca
AU - Zenilman, Ariela L.
AU - Wynn, Julia
AU - Aspelund, Gudrun
AU - Khlevner, Julie
AU - Krishnan, Usha
AU - Lim, Foong Yen
AU - Mychaliska, George B.
AU - Warner, Brad W.
AU - Cusick, Robert
AU - Crombleholme, Timothy
AU - Chung, Dai
AU - Danko, Melissa E.
AU - Wagner, Amy J.
AU - Azarow, Kenneth
AU - Schindel, David
AU - Potoka, Douglas
AU - Soffer, Sam
AU - Fisher, Jason
AU - McCulley, David
AU - Farkouh-Karoleski, Christiana
AU - Chung, Wendy K.
AU - Duron, Vincent
N1 - Funding Information:
This work was supported by NIH grants R01HD057036 (L.Y., J.W., W.K.C.), R03HL138352 (A.K., W.K.C., Y.S.), R01GM120609 (H.Q., Y.S.), UL1 RR024156 (W.K.C.), and 1P01HD068250 (P.K.D, M.L., F.A.H., J.M.W., W.K.C., Y.S.). Additional funding support was provided by grants from CHERUBS , CDHUK , and the National Greek Orthodox Ladies Philoptochos Society, Inc. and generous donations from Fore Hadley , the Williams Family , Wheeler Foundation , Vanech Family Foundation , Larsen Family , Wilke Family and many other families.
Funding Information:
This work was supported by NIH grants R01HD057036 (L.Y. J.W. W.K.C.), R03HL138352 (A.K. W.K.C. Y.S.), R01GM120609 (H.Q. Y.S.), UL1 RR024156 (W.K.C.), and 1P01HD068250 (P.K.D, M.L. F.A.H. J.M.W. W.K.C. Y.S.). Additional funding support was provided by grants from CHERUBS, CDHUK, and the National Greek Orthodox Ladies Philoptochos Society, Inc. and generous donations from Fore Hadley, the Williams Family, Wheeler Foundation, Vanech Family Foundation, Larsen Family, Wilke Family and many other families.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/1
Y1 - 2020/1
N2 - Background: Congenital diaphragmatic hernia (CDH) occurs in 1 out of 2500–3000 live births. Right-sided CDHs (R-CDHs) comprise 25% of all CDH cases, and data are conflicting on outcomes of these patients. The aim of our study was to compare outcomes in patients with right versus left CDH (L-CDH). Methods: We analyzed a multicenter prospectively enrolled database to compare baseline characteristics and outcomes of neonates enrolled from January 2005 to January 2019 with R-CDH vs. L-CDH. Results: A total of 588, 495 L-CDH, and 93 R-CDH patients with CDH were analyzed. L-CDHs were more frequently diagnosed prenatally (p = 0.011). Lung-to-head ratio was similar in both cohorts. R-CDHs had a lower frequency of primary repair (p = 0.022) and a higher frequency of need for oxygen at discharge (p = 0.013). However, in a multivariate analysis, need for oxygen at discharge was no longer significantly different. There were no differences in long-term neurodevelopmental outcomes assessed at two year follow up. There was no difference in mortality, need for ECMO, pulmonary hypertension, or hernia recurrence. Conclusion: In this large series comparing R to L-CDH patients, we found no significant difference in mortality, use of ECMO, or pulmonary complications. Our study supports prior studies that R-CDHs are relatively larger and more often require a patch or muscle flap for repair. Type of study: Prognosis study Level of evidence: Level II
AB - Background: Congenital diaphragmatic hernia (CDH) occurs in 1 out of 2500–3000 live births. Right-sided CDHs (R-CDHs) comprise 25% of all CDH cases, and data are conflicting on outcomes of these patients. The aim of our study was to compare outcomes in patients with right versus left CDH (L-CDH). Methods: We analyzed a multicenter prospectively enrolled database to compare baseline characteristics and outcomes of neonates enrolled from January 2005 to January 2019 with R-CDH vs. L-CDH. Results: A total of 588, 495 L-CDH, and 93 R-CDH patients with CDH were analyzed. L-CDHs were more frequently diagnosed prenatally (p = 0.011). Lung-to-head ratio was similar in both cohorts. R-CDHs had a lower frequency of primary repair (p = 0.022) and a higher frequency of need for oxygen at discharge (p = 0.013). However, in a multivariate analysis, need for oxygen at discharge was no longer significantly different. There were no differences in long-term neurodevelopmental outcomes assessed at two year follow up. There was no difference in mortality, need for ECMO, pulmonary hypertension, or hernia recurrence. Conclusion: In this large series comparing R to L-CDH patients, we found no significant difference in mortality, use of ECMO, or pulmonary complications. Our study supports prior studies that R-CDHs are relatively larger and more often require a patch or muscle flap for repair. Type of study: Prognosis study Level of evidence: Level II
KW - Congenital diaphragmatic hernia
KW - Critical care
KW - ECMO
KW - Thoracic
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U2 - 10.1016/j.jpedsurg.2019.09.046
DO - 10.1016/j.jpedsurg.2019.09.046
M3 - Article
C2 - 31677822
AN - SCOPUS:85074462838
SN - 0022-3468
VL - 55
SP - 33
EP - 38
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 1
ER -