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

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorNAM, Camila Pinho Brasileiro Martins
dc.contributor.authorCAMPOS, Carolina Vieira
dc.contributor.authorLEAL, Gabriela Nunes
dc.contributor.authorTANNURI, Uenis
dc.contributor.authorCECCON, Maria Esther Jurfest Rivero
dc.contributor.authorCARVALHO, Werther Brunow de
dc.date.accessioned2023-08-16T18:01:54Z
dc.date.available2023-08-16T18:01:54Z
dc.date.issued2023
dc.description.abstractObjective: 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.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationCLINICS, v.78, article ID 100217, 6p, 2023
dc.identifier.doi10.1016/j.clinsp.2023.100217
dc.identifier.eissn1980-5322
dc.identifier.issn1807-5932
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/54758
dc.language.isoeng
dc.publisherELSEVIER ESPANAeng
dc.relation.ispartofClinics
dc.rightsopenAccesseng
dc.rights.holderCopyright ELSEVIER ESPANAeng
dc.subjectCongenital Diaphragmatic Herniaeng
dc.subjectNeonatal Intensive Careeng
dc.subjectOxygenation Indexeng
dc.subjectMortalityeng
dc.subjectPrognosiseng
dc.subject.othercongenital diaphragmatic-herniaeng
dc.subject.otherpulmonary-hypertensioneng
dc.subject.othersurvivaleng
dc.subject.otheroutcomeseng
dc.subject.otherechocardiographyeng
dc.subject.otherfetuseseng
dc.subject.wosMedicine, General & Internaleng
dc.titlePost-natal prognostic factors in CDH: experience of 11 years in a referral center in Brazileng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcCAMILA PINHO BRASILEIRO MARTINS NAM
hcfmusp.contributor.author-fmusphcCAROLINA VIEIRA DE CAMPOS
hcfmusp.contributor.author-fmusphcGABRIELA NUNES LEAL
hcfmusp.contributor.author-fmusphcUENIS TANNURI
hcfmusp.contributor.author-fmusphcMARIA ESTHER JURFEST RIVERO CECCON
hcfmusp.contributor.author-fmusphcWERTHER BRUNOW DE CARVALHO
hcfmusp.description.articlenumber100217
hcfmusp.description.volume78
hcfmusp.origemWOS
hcfmusp.origem.pubmed37247561
hcfmusp.origem.scieloSCIELO:S1807-59322023000100248
hcfmusp.origem.scopus2-s2.0-85160500096
hcfmusp.origem.wosWOS:001008656900001
hcfmusp.publisher.cityMADRIDeng
hcfmusp.publisher.countrySPAINeng
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