Related Experiment Video
Updated: May 25, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
The congenital diaphragmatic hernia composite prognostic index correlates with survival in left-sided congenital
Louis D Le1, Sundeep G Keswani, Jacek Biesiada
1The Fetal Care Center of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45267, USA.
Insights
The congenital diaphragmatic hernia congenital prognostic index (CDH-CPI) accurately predicts survival in infants with left-sided congenital diaphragmatic hernia. This comprehensive index shows a stronger correlation with survival than individual prognostic variables.
Area of Science:
- Pediatric Surgery
- Neonatology
- Medical Informatics
Background:
- Congenital diaphragmatic hernia (CDH) is a serious birth defect.
- Accurate prenatal prognostication is crucial for managing CDH.
- Existing prognostic tools may not fully capture disease severity.
Purpose of the Study:
- To validate the Congenital Diaphragmatic Hernia Congenital Prognostic Index (CDH-CPI) for predicting survival in left-sided CDH.
- To assess if the CDH-CPI outperforms individual prognostic factors.
Main Methods:
- Retrospective review of 64 patients with prenatally diagnosed left-sided CDH (2004-2010).
- Collection and tabulation of 10 prenatal parameters to calculate the CDH-CPI score.
- Stratification of patients based on CDH-CPI scores and survival outcomes.
Main Results:
- Patients with a CDH-CPI score ≥ 8 demonstrated significantly higher survival rates.
- The CDH-CPI exhibited the strongest correlation with survival compared to individual parameters.
- CDH-CPI scores correlated with extracorporeal membrane oxygenation (ECMO) use; 75% of patients with scores ≤ 5 required ECMO.
Conclusions:
- The CDH-CPI effectively stratifies survival risk in neonates with left-sided CDH.
- Combining 10 prenatal parameters into the CDH-CPI offers superior prenatal predictive accuracy over single variables.
Purpose:
We developed the congenital diaphragmatic hernia congenital prognostic index (CDH-CPI) to incorporate all known prognostic variables into a single composite index to improve prognostic accuracy. The purpose of this study is to examine the ability of the CDH-CPI to predict survival in patients with left-sided congenital diaphragmatic hernia and to determine if the index has a stronger correlation with survival than each of the individual components.
Methods:
A retrospective review of patients with left-sided congenital diaphragmatic hernia between 2004 and 2010 was conducted. Ten prenatal parameters of the CDH-CPI were collected, total score was tabulated, and patients stratified according to total score and survival.
Results:
Sixty-four patients with a prenatal diagnosis of left-sided congenital diaphragmatic hernia were identified. Patients with a CDH-CPI score of 8 or higher had a significantly higher survival than patients with a CDH-CPI score of lower than 8. The CDH-CPI has the strongest correlation with survival compared with the individual parameters measured. The CDH-CPI correlates with extracorporeal membrane oxygenation use, and 75% of patients with a score of 5 or lower were placed on extracorporeal membrane oxygenation.
Conclusions:
The CDH-CPI accurately stratifies survival in left-sided congenital diaphragmatic hernia. The amalgamation of 10 prenatal parameters of the CDH-CPI may be a better prenatal predictor than any single prognostic variable currently used.
