Abstract
Purpose: The aim of the study was to examine national outcomes for congenital diaphragmatic hernia (CDH). Methods: We analyzed the Kids' Inpatient Database for patients admitted at less than 8 days of age. Results: Overall, 2774 hospitalizations were identified. Most patients were white and had private insurance. Most patients were treated at urban (96%), teaching (75%), and not identified as children's hospital (NIACH) (50%). Birth was the most common admission source at NIACH (91%) and children's unit in general hospital (CUGH) (59%), compared to hospital transfer at children's general hospital (CGH) (81%). Most CDH were repaired through the abdomen (81%), and 25% required extracorporeal membrane oxygenation (ECMO). Most NIACH patients were transferred to another hospital, whereas most at CGH and CUGH were discharged home. Survival to discharge was 66% after excluding hospital transfers. Univariate analysis revealed higher survival for males, birth weight (BW) of 3 kg or more, whites, patients with private insurance, and those in the highest median household income quartile. Survival was 86% after CDH repair but 46% for ECMO. Multivariate analysis identified black race (hazard ratio [HR], 1.536; P = .03) and other race (HR, 1.515; P = .03) as independent predictors of mortality. Conclusions: Hospital survival for CDH is related to sex, BW, race, and socioeconomic status. Blacks and other non-Hispanic minorities have higher mortality rates.
| Original language | English |
|---|---|
| Pages (from-to) | 1336-1342 |
| Number of pages | 7 |
| Journal | Journal of Pediatric Surgery |
| Volume | 45 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2010 |
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Keywords
- Congenital diaphragmatic hernia
- KID
- Outcomes
- Population-based study
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
Survival disparities in newborns with congenital diaphragmatic hernia : a national perspective. / Sola, Juan E; Bronson, Steven N.; Cheung, Michael C.; Ordonez, Beatriz; Neville, Holly; Koniaris, Leonidas G.
In: Journal of Pediatric Surgery, Vol. 45, No. 6, 01.06.2010, p. 1336-1342.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Survival disparities in newborns with congenital diaphragmatic hernia
T2 - a national perspective
AU - Sola, Juan E
AU - Bronson, Steven N.
AU - Cheung, Michael C.
AU - Ordonez, Beatriz
AU - Neville, Holly
AU - Koniaris, Leonidas G.
PY - 2010/6/1
Y1 - 2010/6/1
N2 - Purpose: The aim of the study was to examine national outcomes for congenital diaphragmatic hernia (CDH). Methods: We analyzed the Kids' Inpatient Database for patients admitted at less than 8 days of age. Results: Overall, 2774 hospitalizations were identified. Most patients were white and had private insurance. Most patients were treated at urban (96%), teaching (75%), and not identified as children's hospital (NIACH) (50%). Birth was the most common admission source at NIACH (91%) and children's unit in general hospital (CUGH) (59%), compared to hospital transfer at children's general hospital (CGH) (81%). Most CDH were repaired through the abdomen (81%), and 25% required extracorporeal membrane oxygenation (ECMO). Most NIACH patients were transferred to another hospital, whereas most at CGH and CUGH were discharged home. Survival to discharge was 66% after excluding hospital transfers. Univariate analysis revealed higher survival for males, birth weight (BW) of 3 kg or more, whites, patients with private insurance, and those in the highest median household income quartile. Survival was 86% after CDH repair but 46% for ECMO. Multivariate analysis identified black race (hazard ratio [HR], 1.536; P = .03) and other race (HR, 1.515; P = .03) as independent predictors of mortality. Conclusions: Hospital survival for CDH is related to sex, BW, race, and socioeconomic status. Blacks and other non-Hispanic minorities have higher mortality rates.
AB - Purpose: The aim of the study was to examine national outcomes for congenital diaphragmatic hernia (CDH). Methods: We analyzed the Kids' Inpatient Database for patients admitted at less than 8 days of age. Results: Overall, 2774 hospitalizations were identified. Most patients were white and had private insurance. Most patients were treated at urban (96%), teaching (75%), and not identified as children's hospital (NIACH) (50%). Birth was the most common admission source at NIACH (91%) and children's unit in general hospital (CUGH) (59%), compared to hospital transfer at children's general hospital (CGH) (81%). Most CDH were repaired through the abdomen (81%), and 25% required extracorporeal membrane oxygenation (ECMO). Most NIACH patients were transferred to another hospital, whereas most at CGH and CUGH were discharged home. Survival to discharge was 66% after excluding hospital transfers. Univariate analysis revealed higher survival for males, birth weight (BW) of 3 kg or more, whites, patients with private insurance, and those in the highest median household income quartile. Survival was 86% after CDH repair but 46% for ECMO. Multivariate analysis identified black race (hazard ratio [HR], 1.536; P = .03) and other race (HR, 1.515; P = .03) as independent predictors of mortality. Conclusions: Hospital survival for CDH is related to sex, BW, race, and socioeconomic status. Blacks and other non-Hispanic minorities have higher mortality rates.
KW - Congenital diaphragmatic hernia
KW - KID
KW - Outcomes
KW - Population-based study
UR - http://www.scopus.com/inward/record.url?scp=77953851270&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953851270&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2010.02.105
DO - 10.1016/j.jpedsurg.2010.02.105
M3 - Article
C2 - 20620341
AN - SCOPUS:77953851270
VL - 45
SP - 1336
EP - 1342
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 6
ER -