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

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


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.


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).


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

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