AI Article Synopsis
- The study examined the incidence and survival outcomes of congenital diaphragmatic hernia (CDH) in Croatia from 2001 to 2013, finding 145 cases with an incidence of 2.67 per 10,000 births.
- Analysis revealed a 1-year survival rate of 33.1%, which increased significantly to 47.9% for liveborns treated in intensive care.
- The findings suggest that higher survival rates are linked to treatment at facilities with greater case volumes, indicating the potential benefit of centralizing CDH care in Croatia.
Article Abstract
Background: Outcomes of neonates with congenital diaphragmatic hernia (CDH) are variable; reports are frequently limited to the experience of single tertiary care centres-a possible source of bias. Population-based studies decrease survivor bias and provide additional insight into this high-mortality condition. The objective of this study was to examine the incidence and outcomes of CDH in Croatia.
Methods: All cases of CDH in Croatia from 2001 through 2013 were ascertained from public health records. Overall and sex- and region-specific incidence rates were calculated, and characteristics associated with 1-year survival were assessed.
Results: We identified 145 cases of CDH during the study period, for an incidence of 2.67 per 10 000 total births. The incidence did not differ by calendar year (P = 0.38) or geographic region (P = 0.67). There was a slightly higher incidence among males (rate ratio, 1.37, 95% CI 0.99, 1.91). The 1-year survival rate was 33.1% for the entire cohort and 47.9% for liveborns who received any treatment at an intensive care unit. From multivariable analysis, survival was decreased in neonates with left CDH, liver up (odds ratio 0.1, 95% CI, 0.03, 0.4) and increased when treated in a centre with higher case volume (odds ratio 12.8, 95% CI, 2.2, 72.1).
Conclusions: The incidence of CDH in Croatia is within the range of previous reports. Survival was substantially higher in neonates treated in a centre with higher case volume, which suggests that centralisation of medical care for CDH may be warranted in Croatia.
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| http://dx.doi.org/10.1111/ppe.12289 | DOI Listing |
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