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One-Year Outcome for Congenital Diaphragmatic Hernia: Results From the French National Register.
Barrière, François; Michel, Fabrice; Loundou, Anderson D; Fouquet, Virginie; Kermorvant, Elsa; Blanc, Sébastien; Carricaburu, Elisabeth; Desrumaux, Amélie; Pidoux, Odile; Arnaud, Alexis; Berte, Nicolas; Blanc, Thierry; Lavrand, Frederic; Levard, Guillaume; Rayet, Isabelle; Samperiz, Sylvain; Schneider, Anne; Marcoux, Marie-Odile; Winer, Norbert; Chaussy, Yann; Datin-Dorriere, Valérie; Ballouhey, Quentin; Binet, Aurélien; Muszynski, Charles; Breaud, Jean; Garenne, Armelle; Storme, Laurent; Boubnova, Julia.
Afiliação
  • Barrière F; Pediatric Intensive Care Unit, La Timone Children Hospital, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University, Marseille, France. Electronic address: francois.barriere@gmail.com.
  • Michel F; Pediatric Intensive Care Unit, La Timone Children Hospital, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University, Marseille, France.
  • Loundou AD; Department of Public Health, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University, Marseille, France.
  • Fouquet V; Department of Pediatric Surgery, Paris South University Hospitals, AP-HP, Le Kremlin-Bicêtre, France.
  • Kermorvant E; Neonatal Intensive Care Unit, Necker-Enfants Malades, AP-HP, Paris Descartes University, Paris, France.
  • Blanc S; Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Bron, France.
  • Carricaburu E; Department of Pediatric Surgery, Robert-Debré Hospital, AP-HP, Paris, France.
  • Desrumaux A; Neonatal Intensive Care Unit, Couple-Enfant Hospital, Grenoble, France.
  • Pidoux O; Department of Neonatology, University Hospital, Montpellier, France.
  • Arnaud A; Department of Pediatric Surgery, Hôpital Sud, University Hospital, Rennes, France.
  • Berte N; Department of Surgery, University Hospital, Nancy, France.
  • Blanc T; Neonatal Intensive Care Unit, University Hospital, Rouen, France.
  • Lavrand F; Department of Pediatric Surgery, University of Bordeaux, Pellegrin-Enfant Hospital, Bordeaux, France.
  • Levard G; Department of Pediatric Surgery, University Hospital, Poitiers, France.
  • Rayet I; Neonatal and Pediatric Intensive Care Unit, Hôpital Nord, Saint-Etienne, France.
  • Samperiz S; Neonatal and Pediatric Intensive Care Unit, Felix Guyon Hospital, La Réunion, France.
  • Schneider A; Department of Pediatric Surgery, Hautepierre Hospital University Medical Center, Strasbourg, France.
  • Marcoux MO; Neonatal Intensive Care Unit, Hôpital des Enfants, Toulouse, France.
  • Winer N; Department of Gynecology and Obstetrics, Hôtel-Dieu University Hospital, Nantes, France.
  • Chaussy Y; Department of Pediatric Surgery, Jean Minjoz University Hospital, Besançon, France.
  • Datin-Dorriere V; Neonatal Intensive Care Unit, Côte de Nacre University Hospital, Caen, France.
  • Ballouhey Q; Department of Pediatric Surgery, University Hospital, Limoges, France.
  • Binet A; Department of Pediatric Surgery, Clocheville University Hospital, Tours, France.
  • Muszynski C; Department of Obstetrics and Gynecology, Amiens University Hospital, Amiens, France.
  • Breaud J; Department of Pediatric Surgery, Nice Pediatric Hospital, University of Nice-Sophia Antipolis, Nice, France.
  • Garenne A; Pediatric Department, Brest University Hospital, Brest, France.
  • Storme L; Department of Neonatal Medicine, Lille University Hospital, Lille, France.
  • Boubnova J; Department of Pediatric Surgery, La Timone Children Hospital, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University, Marseille, France.
J Pediatr ; 193: 204-210, 2018 02.
Article em En | MEDLINE | ID: mdl-29212620
OBJECTIVE: To evaluate the status of congenital diaphragmatic hernia (CDH) management in France and to assess predictors of adverse outcomes. STUDY DESIGN: We reviewed the first-year outcome of all cases of CDH reported to the French National Register in 2011. RESULTS: A total of 158 cases were included. Of these, 83% (131) were prenatally diagnosed, with a mortality rate of 39% (44 of 112) for live born infants with a known outcome at hospital discharge. Mortality increased to 47% (60 of 128) including those with termination of pregnancy and fetal loss. This contrasts with the 7% (2 of 27) mortality rate of the patients diagnosed postnatally (P = .002). Mortality worsened with 1 prenatal marker of CDH severity (OR 3.38 [1.30-8.83] P = .013) and worsened further with 2 markers (OR 20.64 [5.29-80.62] P < .001). Classic postnatal risk factors of mortality such as side of hernia (nonleft P = .001), prematurity (P < .001), low birth weight (P = .002), and size of the defect (P < .001) were confirmed. Of the 141 live births (114 prenatal and 27 postnatal diagnosis) with known outcomes, 93 (67%) survived to hospital discharge, 68 (60%) with a prenatal diagnosis and 25 (93%) with a postnatal diagnosis. The median time to hospital discharge was 34 days (IQR, 19.25-62). Of these survivors, 71 (76%) were followed up for 1 year. CONCLUSIONS: Despite advances in management of CDH, mortality was high and associated with prenatal risk factors. Postnatally, severe persistent pulmonary hypertension was difficult to predict and presented persistent challenges in management.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hérnias Diafragmáticas Congênitas Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn / Pregnancy País/Região como assunto: Europa Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hérnias Diafragmáticas Congênitas Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn / Pregnancy País/Região como assunto: Europa Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos