Survival disparities in newborns with congenital diaphragmatic hernia: a national perspective

  • Sola J
  • Bronson S
  • Cheung M
 et al. 
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Abstract

Purpose: The aim of the study was to examine national outcomes for congenital diaphragmatic hernia (CDH). Methods: We analyzed the Kids' Inpatient Database for patients admitted at less than 8 days of age. Results: Overall, 2774 hospitalizations were identified. Most patients were white and had private insurance. Most patients were treated at urban (96%), teaching (75%), and not identified as children's hospital (NIACH) (50%). Birth was the most common admission source at NIACH (91%) and children's unit in general hospital (CUGH) (59%), compared to hospital transfer at children's general hospital (CGH) (81%). Most CDH were repaired through the abdomen (81%), and 25% required extracorporeal membrane oxygenation (ECMO). Most NIACH patients were transferred to another hospital, whereas most at CGH and CUGH were discharged home. Survival to discharge was 66% after excluding hospital transfers. Univariate analysis revealed higher survival for males, birth weight (BW) of 3 kg or more, whites, patients with private insurance, and those in the highest median household income quartile. Survival was 86% after CDH repair but 46% for ECMO. Multivariate analysis identified black race (hazard ratio [HR], 1.536; P = .03) and other race (HR, 1.515; P = .03) as independent predictors of mortality. Conclusions: Hospital survival for CDH is related to sex, BW, race, and socioeconomic status. Blacks and other non-Hispanic minorities have higher mortality rates. © 2010 Elsevier Inc. All rights reserved.

Author-supplied keywords

  • Congenital diaphragmatic hernia
  • KID
  • Outcomes
  • Population-based study

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