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Published on: May 11, 2015
Pulmonary hypertension predicts mortality in infants with omphalocele
J E Baerg1, D L Thorpe1, N E Sharp2
1Loma Linda University Children's Hospital, Loma Linda, CA, USA.
Insights
Respiratory insufficiency and pulmonary hypertension are key predictors of mortality in infants with omphalocele. Identifying these factors early can improve infant outcomes and survival rates.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Critical Care
Background:
- Omphalocele is a congenital abdominal wall defect with significant associated mortality.
- Predicting mortality in affected infants is crucial for timely intervention and resource allocation.
Purpose of the Study:
- To identify independent predictors of mortality in infants diagnosed with omphalocele.
- To analyze factors associated with increased risk of death in this vulnerable population.
Main Methods:
- Retrospective review of medical records for infants with omphalocele (1992-2012).
- Comparison of survivors and non-survivors, focusing on respiratory and cardiovascular parameters.
- Logistic regression analysis to determine independent predictors of mortality.
Main Results:
- 25% of infants with omphalocele in the study cohort died.
- Respiratory insufficiency at birth (OR: 14.8) and pulmonary hypertension (OR: 6.4) were significantly associated with mortality.
- Pulmonary hypertension was defined by increased right ventricular pressures on echocardiogram.
Conclusions:
- Respiratory insufficiency and pulmonary hypertension are independent predictors of mortality in infants with omphalocele.
- Early identification and management of these conditions may improve survival rates for infants with omphalocele.
Objective:
The objective of this study was to identify predictors of mortality in infants with omphalocele.
Methods:
Medical records of infants with omphalocele born between January 1992 and June 2012, with follow-up toDecember 2012, were retrospectively reviewed. Survivors and non-survivors were compared. Evidence for pulmonary hypertension was sought between the second and seventh day after birth. All included infants had increased right ventricular pressures (RVP >40 mmhg) on echocardiogram on the second day of life with increased oxygen requirements, therefore, the finding of increased pressure was not considered a result of the transitional circulation. Logistic regression was used to evaluate the importance and independence of various factors.
Results:
Of 51 infants whose records were reviewed, 13 died (25%) and 38 survived (75%). The median time to death was 34 days (range: 4 -408 days). The median follow-up time for those who died was 1.5 years (range: 0.01-15 years) and for survivors was 2.6 years (range: 0.08-15 years). Logistic regression revealed that respiratory insufficiency at birth (OR: 14.8; 95% CI: 2.5-85.0) and pulmonary hypertension (OR: 6.4; 95% CI: 1.1-39.0) were independently associated with mortality.
Conclusion:
Respiratory insufficiency after birth and pulmonary hypertension are independent predictors of mortality in infants with omphalocele.
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