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Risk of Readmission for Wheezing during Infancy in Children with Congenital Diaphragmatic Hernia

Gregoire Benoist1, Mostafa Mokhtari2, Antoine Deschildre3

  • 1Pneumologie Pédiatrique, Necker, AP-HP, Paris, France, Centre de Référence des Maladies Respiratoires Rares, Paris, France.

Plos One
|May 13, 2016
PubMed

Insights

Infants with congenital diaphragmatic hernia (CDH) have frequent respiratory issues and high readmission rates for wheezing. Several factors influence these readmissions, but palivizumab did not reduce them.

Area of Science:

  • Pediatric Pulmonology
  • Neonatal Surgery
  • Clinical Epidemiology

Background:

  • Congenital diaphragmatic hernia (CDH) is linked to significant respiratory morbidity post-discharge.
  • The frequency of infant re-hospitalization for respiratory issues in CDH patients is not well-established.

Purpose of the Study:

  • To determine the readmission rate for wheezing in infants with CDH up to 24 months of age.
  • To identify risk factors associated with wheezing-related readmissions in this population.

Main Methods:

  • A prospective national database analysis of infants with CDH born in French tertiary centers (2009-2013).
  • Inclusion criteria: infants alive at discharge; data extraction for wheezing episodes and readmissions up to 24 months.
  • Statistical analysis to identify factors associated with readmission.

Main Results:

  • 26% of 86 infants with CDH were readmitted for wheezing exacerbations before 24 months.
  • Factors associated with readmission included thoracic liver herniation, low gestational age, prolonged initial hospitalization, home oxygen use, and eczema.
  • Respiratory Syncytial Virus (RSV) was detected in 40% of first readmissions with available samples.
  • Palivizumab prophylaxis did not correlate with reduced readmission rates or RSV hospitalizations.

Conclusions:

  • Infants with CDH experience a high rate of readmission for wheezing exacerbations.
  • Prenatal and neonatal factors significantly influence readmission risk.
  • Palivizumab prophylaxis showed no impact on reducing wheezing-related readmissions in this cohort.
Abstract

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