Is laterality of congenital diaphragmatic hernia a reliable prognostic factor? French national cohort study.
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Pinton Anne, Boubnova Julia, Becmeur François, Kuhn Pierre, Senat Marie-Victoire, Stirnemann Julien, Capelle Marianne, Rosenblatt Jonathan, Massardier Jérôme, Vaast Pascal, Le Bouar Gwenaelle, Desrumaux Amélie, Connant Laure, Begue Laetitia, Parmentier Benoit, Perrotin Franck, Diguet Alain, Benoist Guillaume, Muszynski Charles, Scalabre Aurélien, Winer Norbert, Michel Jean-Luc, Casagrandre-Magne Florence, Jouannic Jean-Marie, Gallot Denis, Coste Mazeau Perrine, Sapin Emmanuel, Maatouk Alexis, Saliou Anne-Hélène, Sentilhes Loïc, Biquard Florence, Mottet Nicolas, Favre Romain, Benachi Alexandra, Sananès Nicolas
Аннотация
METHODS: This was a cohort study using the French national database of the Reference Center for Diaphragmatic Hernias. The principal endpoint was survival after hospitalization in intensive care. We made a comparative study between right CDH and left CDH by univariate and multivariate analysis. Terminations and stillbirths were excluded from analyses of neonatal outcomes.
RESULTS: A total of 506 CDH were included with 67 (13%) right CDH and 439 left CDH (87%). Rate of survival was 49% for right CDH and 74% for left CDH (P < .01). Multivariate analysis showed two factors significantly associated with mortality: thoracic herniation of liver (OR 2.27; IC 95% [1.07-4.76]; P = .03) and lung-to-head-ratio over under expected (OR 2.99; IC 95% [1.41-6.36]; P < .01). Side of CDH was not significantly associated with mortality (OR 1.87; IC 95% [0.61-5.51], P = .26).
CONCLUSION: Rate of right CDH mortality is more important than left CDH. Nevertheless after adjusting for lung-to-head-ratio and thoracic herniation of liver, right CDH does not have a higher risk of mortality than left CDH.