Congenital Diaphragmatic Hernia, Predictors of Survival and Adverse Outcomes

Abstract

Abstract Objective: To examine prenatal and postnatal predictors of survival in infants with Congenital Diaphragmatic Hernia (CDH). Method: Six- years retrospective review of all cases of CDH born at King Abdulaziz Medical City , Riyadh, Kingdom of Saudi Arabia . Results: Twenty-seven infants (67.5%) survived to discharge. Non-survivors had a higher best , mean and highest OI (P<0.001) in day 1 compared to survivors. Best (AUC = 0.917), mean (AUC=0.945) and highest (AUC=0.923) OI in day 1 were all highly predictive of mortality. There was a significant correlation between the preoperative OI and time to surgery (TTS) (rS =0.462, P=0.017) and the length of hospital stay (LOS) (rS =0.458, P=0.019). Mean day 1 OI had a significant correlation with the duration of ventilation (DOV) (rS =0.549, P=0.004) and the TTS (rS =0.526, P=0.007) and the LOS (rS =0.497, P=0.012). Best and highest day 1 OI also correlated significantly with DOV, TTS and LOS. Conclusion: Our CDH survival rates of 67.5% are comparable to those of other international studies despite the lack of ECMO utilization and antenatal interventions. First day oxygenation indices were excellent predictors of survival and have a significant correlation with the DOV, LOS and TTS in infants with CDH.