APSA paperThe congenital diaphragmatic hernia composite prognostic index correlates with survival in left-sided congenital diaphragmatic hernia
Section snippets
Patient data
A retrospective review of medical records for all patients with left-sided CDH evaluated prenatally at the Fetal Care Center (FCC) of Cincinnati and treated postnatally at Cincinnati Children's Hospital Medical Center between 2004 and 2010 was conducted. This study was approved by the institutional review board (IRB no. 2008-0894). Patients generally had 2 visits to the FCC with imaging performed at both visits. A fetal magnetic resonance imaging (MRI), ultrasound, and echocardiogram are
Study population
Of a total of 73 cases of CDH evaluated prenatally at the FCC, we identified 64 patients with a prenatal diagnosis of left-sided CDH and postnatal treatment at our institution. The average gestational age of patients seen during the first visit is 24 5/6 weeks (range, 19 1/7-30 2/7 weeks), and the average gestational age of patients seen at the second visit is 34 1/7 weeks (range, 31-37 5/7 weeks). The overall survival of this population is 65.6% (42/64). Table 1 contains the data of the 10
Discussion
The results of this single institution retrospective study suggest that the CDH-CPI may provide useful information for the counseling of parents with a fetus that has been diagnosed with an isolated left-sided CDH. There is a positive correlation between CDH-CPI score and survival. Patients with a score of 8 or higher have excellent outcomes with survival approaching 90%, whereas patients with scores lower than 8 had significantly decreased survival. A primary end point of this study was to
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