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Survival rate changes in children with congenital diaphragmatic hernia over the past three decades: a nationwide,
B Kutasy1, C M Burgos2,3
1Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden. Balazs.kutasy@regionstockholm.se.
Insights
Survival rates for congenital diaphragmatic hernia (CDH) have significantly improved over three decades. This progress is attributed to better survival in both premature and non-premature CDH patients.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Public Health
Background:
- Congenital diaphragmatic hernia (CDH) is a serious condition affecting newborns.
- While survival rates for CDH have historically been a concern, recent decades have seen advancements.
Purpose of the Study:
- To investigate trends in survival rates for children with congenital diaphragmatic hernia (CDH) over several decades.
- To analyze changes in survival over time for neonates diagnosed with CDH.
Main Methods:
- A nationwide, population-based, prospective nested case-control study.
- Data collected from newborn infants in Sweden between January 1, 1982, and December 31, 2015.
Main Results:
- The 2-year survival rate for children with CDH improved significantly over the past three decades.
- Patients with CDH had a 5.8 times higher risk of not surviving to 2 years compared to controls.
- Improved survival was observed in both premature and non-premature CDH patients.
Conclusions:
- Survival rates for congenital diaphragmatic hernia (CDH) patients have markedly increased over the last 30 years.
- The enhanced survival is linked to better outcomes for both premature and full-term infants with CDH.
Purpose:
The survival rate (SR) for neonates born with congenital diaphragmatic hernia (CDH) remains high. Our aim was to investigate the change in SR in children with CDH over the past decades.
Methods:
The study was a nationwide, population-based prospective nested case-control study within a cohort of newborn children who was born in Sweden during the observational period from 1st January 1982 to 31st December 2015.
Results:
In the study period, 4654 (99.6%) control children and 684 children with CDH (70.4%, p < 0.001) were with a survival of 2 years of age. Any patients who were born with CDH had a overall 5.8 times higher chance for not surviving 2 years of age than children without CDH. The SR improved significantly in CDH in the past 3 decades. Significantly higher number of patients were prematurely born in the CDH group than in the controls (23.3 vs 6.1%, p < 0.001). The SR of premature and non-premature born CDH patients has increased significantly over the past 3 decades.
Conclusion:
The SR of CDH patients were significantly increased in the past 3 decades. The 2-year survival remains 5.8 times higher than those who were not born with CDH. These changes were mainly attributed to the improved SR of premature and non-premature born CDH patients.
