Early, Postnatal Pulmonary Hypertension Severity Predicts Inpatient Outcomes in Congenital Diaphragmatic Hernia

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dc.catalogadoryvc
dc.contributor.authorMunves Ferguson, Dalya
dc.contributor.authorGupta, Vikas S.
dc.contributor.authorLally, Pamela A.
dc.contributor.authorLuco Illanes, Matías Fernando
dc.contributor.authorTsao, KuoJen
dc.contributor.authorLally, Kevin P.
dc.contributor.authorPatel, Neil
dc.contributor.authorHarting, Matthew T.
dc.date.accessioned2024-01-19T14:06:45Z
dc.date.available2024-01-19T14:06:45Z
dc.date.issued2021
dc.description.abstractIntroduction: Pulmonary hypertension (PH) is the major pathophysiologic consequence of congenital diaphragmatic hernia (CDH). We aimed to evaluate the association between early CDH-associated PH (CDH-PH) and inpatient outcomes. Methods: The CDH Study Group registry was queried for infants born 2015-2019 with echocardiograms before 48h of life. PH was categorized using echocardiographic findings: none, mild (right ventricular systolic pressure <2/3 systemic), moderate (between 2/3 systemic and systemic), or severe (supra-systemic). Univariate and multivariate analyses were performed. Adjusted Poisson regression was used to assess the primary composite outcome of mortality or oxygen support at 30 days. Results: Of 1,472 patients, 86.5% had CDH-PH: 13.9% mild (n = 193), 44.4% moderate (n = 631), and 33.2% severe (n = 468). On adjusted analysis, the primary outcome of mortality or oxygen support at 30 days occurred more frequently in infants with moderate (incidence rate ratio [IRR] 1.8, 95% confidence interval [CI], 1.2-2.6) and severe CDH-PH (IRR 2.0, 95% CI, 1.3-2.9). Extracorporeal life support (ECLS) utilization was associated only with severe CDH-PH after adjustment (IRR 1.8, 95% CI, 1.0-3.3). Discussion/conclusion: Early, postnatal CDH-PH is independently associated with increased risk for mortality or oxygen support at 30 days and utilization of ECLS. Early echocardiogram is a valuable prognostic tool for early, inpatient outcomes in neonates with CDH.
dc.fuente.origenORCID
dc.identifier.doi10.1159/000512966
dc.identifier.pubmedid33849011
dc.identifier.scopusidSCOPUS_ID:85107712746
dc.identifier.urihttps://doi.org/10.1159/000512966
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/80639
dc.identifier.wosidWOS:000640279700001
dc.information.autorucEscuela de Medicina; Luco Illanes, Matías Fernando; 0000-0002-7698-8065; 7023
dc.issue.numero2
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final154
dc.pagina.inicio147
dc.rightsacceso restringido
dc.subjectCongenital diaphragmatic hernia
dc.subjectEchocardiography
dc.subjectMortality
dc.subjectNeonatal outcomes;
dc.subjectPulmonary hypertension
dc.subject.ddc610
dc.subject.deweyMedicina y salud
dc.titleEarly, Postnatal Pulmonary Hypertension Severity Predicts Inpatient Outcomes in Congenital Diaphragmatic Hernia
dc.typeartículo
dc.volumen118
sipa.codpersvinculados7023
sipa.trazabilidadORCID;2024-01-08
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