Post-natal prognostic factors in CDH: experience of 11 years in a referral center in Brazil

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art_NAM_Postnatal_prognostic_factors_in_CDH_experience_of_11_2023.PDF (500.48 KB)
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0
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article
Data de publicação
2023
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Scopus
Web of Science
PubMed
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ELSEVIER ESPANA
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CLINICS, v.78, article ID 100217, 6p, 2023
Projetos de Pesquisa
Unidades Organizacionais
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Objective: To describe post-natal risk factors associated with death in Newborns (NB) with Congenital Diaphragmatic Hernia (CDH) in a Brazilian reference center.Methods: In this retrospective cohort study, post-natal clinical factors of all NB diagnosed with CDH were reviewed in an 11-year period (2007-2018). The primary outcome was death. Secondary outcomes included clinical features, prognostic indexes, type of mechanical ventilation, complications during hospitalization and surgical repair.Results: After applying the exclusion criteria, the authors analyzed 137 charts. Overall mortality was 59% (81/ 137), and the highest rates were observed for low-birth-weight NB (87%), syndromic phenotype (92%), and those with major malformations (100%). Prognostic indexes such as Apgar, SNAPPE-II and 24hOI (best oxygenation index in 24 hours) were all associated with poor evolution. In a multivariate analysis, only birth weight and 24hOI were statistically significant risk factors for mortality, with a reduction in mortality risk of 17.1% (OR = 0.829, 95% IC 0.72-0.955, p = 0.009) for each additional 100g at birth and an increase by 26.5% (OR = 1.265, 95% IC 1.113-1.436, p = 0.0003) for each unitary increase at the 24hOI.Conclusion: Prognostic indexes are an important tool for predicting outcomes and improving resource allocation. Post-natal risk factors may be more suitable for settings where antenatal diagnosis is not universal. Classical risk factors, such as prematurity, low birth weight, higher need for supportive care, and poorer prognostic indexes were associated with mortality in our CDH population.
Palavras-chave
Congenital Diaphragmatic Hernia, Neonatal Intensive Care, Oxygenation Index, Mortality, Prognosis
URI
https://observatorio.fm.usp.br/handle/OPI/54758
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/09
Artigos e Materiais de Revistas Científicas - LIM/30
Artigos e Materiais de Revistas Científicas - LIM/36