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  • Original Article
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Risk stratification for congenital diaphragmatic hernia by factors within 24 h after birth

Abstract

Objective:

To establish a simple risk stratification system for patients with congenital diaphragmatic hernia (CDH) based on postnatal information within 24 h after birth.

Study Design:

A multi-institutional retrospective cohort study was conducted including 348 neonates who had isolated CDH born between 2006 and 2010. Based on the two most powerful variables for 90-day survival selected by multivariate analyses, a risk stratification system was established.

Results:

Multiple logistic regression analysis identified two adverse prognostic factors: an Apgar score at 1 min (Ap1) of 0–4 (odds ratio (OR) 3.3, P=0.004), and a best oxygenation index (OI) 8.0 (OR 11.4, P<0.001). Based on a combinations of these two factors, patients were classified into three risk categories. The 90-day survival rates in categories 1–3 were 100, 88 and 52%, respectively (P<0.001).

Conclusion:

Our simple risk stratification system based on Ap1 and best OI was capable of predicting mortality well.

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Acknowledgements

We thank all institutions that collected the data used for the present study. We are grateful to Dr Yasunori Sato (Clinical Research Center, Chiba University Hospital) for supervising the statistical analyses. This work was supported by a grant from the Ministry of Health, Labour and Welfare of Japan (Health and Labour Sciences Research Grants for Research on Intractable Disease).

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Correspondence to K Terui.

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Terui, K., Nagata, K., Kanamori, Y. et al. Risk stratification for congenital diaphragmatic hernia by factors within 24 h after birth. J Perinatol 37, 805–808 (2017). https://doi.org/10.1038/jp.2017.11

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