Epidemiology and Outcomes of Congenital Diaphragmatic Hernia in Croatia: A Population-Based Study
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...
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Published in | Paediatric and perinatal epidemiology Vol. 30; no. 4; pp. 336 - 345 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Blackwell Publishing Ltd
01.07.2016
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | 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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Bibliography: | Table S1. Incidence of Congenital Diaphragmatic Hernia (CDH) in Croatia Between 2001 and 2013: Overall, by Sex, and by Country Region. Table S2. Congenital Anomalies in Patients With CDH.Figure S1. Map of Croatia. Three regions are indicated according to referral to paediatric referral centres. Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota ark:/67375/WNG-N5KMKWXL-L ArticleID:PPE12289 istex:ADFD628B09680DB5363E18D83F755A8B7DD072C2 Equal contributors. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0269-5022 1365-3016 |
DOI: | 10.1111/ppe.12289 |