Article Text

SURVIVAL OF INFANTS WITH CONGENITAL DIAPHRAGMATIC HERNIA ADMITTED TO A TERTIARY PAEDIATRIC SURGICAL CENTRE
  1. J Chukwu1,
  2. C Iro1,
  3. N McCallion2,
  4. F Quinn1,
  5. E J Molloy1,2
  1. 1Department of Neonatology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
  2. 2Department of Neonatology, National Maternity Hospital, Dublin, Ireland

Abstract

Introduction Congenital diaphragmatic hernia (CDH) is a rare malformation observed in approximately 1 in 3000 live births. Estimates of postnatal survival range from 50 to 70% despite advances in neonatal care. Antenatal diagnosis is associated with termination of pregnancy in 25–50% pregnancy in international literature which may not be reflective of the Irish population

Aims We aimed to evaluate the mortality of infants with CDH who survived to admission in a tertiary referral paediatric hospital between 1996–2007.

Methods The Hospital In-Patient Enquiry (HIPE) system was used to determine the number of neonatal referrals for CDH to OLHSC between January 1st 1996–December 31st 2007. Mortality, sex distribution, length of patient stay and the number of cases per year were examined.

Results 112 neonates with CDH were admitted during the study period average of 9.4 referrals per annum. 63 (55%) males, and 50 (45%) females. The average (+/−SD) length of stay in the hospital was 35+/−49 days (range 0–264 days). Overall 79 (70.%) of the patients survived to discharge. In the first epoch (1996–2001) survival was 63% compared with 82% in the later epoch (2002–7).

Conclusions The overall survival for neonates with CDH presenting to OLCHC during the 12 year-period under review was 70% which is comparable with other tertiary referral centres. However survival rates >90% are reported in tertiary referral paediatric surgical centres. Further study of associated congenital anomalies,complexity of the diaphragmatic defect and degree of pulmonary hypertension are required to compare this population with international centres.

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