Evaluating mortality and disease severity in congenital diaphragmatic hernia using the McGoon and pulmonary artery indices

Shigehiro Takahashi, Yoshihisa Oishi, Naoki Ito, Yukiko Nanba, Keiko Tsukamoto, Tomoo Nakamura, Yushi Ito, Satoshi Hayashi, Haruhiko Sago, Tatsuo Kuroda, Toshiro Honna

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: Lung hypoplasia is associated with mortality in congenital diaphragmatic hernia (CDH). However, the association between lung hypoplasia and disease severity is unclear. Early prediction of disease severity would provide parents with more precise information about the anticipated course of treatment, minimize treatment disruption, and maximize the efficient management of patients with CDH. We aimed at identifying the relationship between McGoon index (MGI) and pulmonary artery index (PAI) scores and disease severity among infants with CDH. Methods: We retrospectively reviewed the medical records of 19 high-risk patients with CDH born between January 2006 and December 2007. McGoon index and PAI scores were determined on admission. We evaluated statistically the relationship between these scores and variables representing severity as follows: number of vasodilators, use of inhaled nitric oxide (iNO), closed method of diaphragm, duration of intubation, duration of hospitalization, and use of home oxygen therapy. Statistical significance was P < .05. Results: Overall median MGI and PAI scores were 1.40 and 108, respectively; scores for nonsurvivors were significantly (P < .05 and P < .01, respectively) lower than those for survivors. Among survivors, PAI scores were significantly (P < .05) lower in infants requiring iNO than in infants not requiring iNO and patch repair. The PAI scores were significantly correlated with the number of vasodilators (r = -0.789; P < .01) and duration of intubation (r = -0.610; P < .05). Conclusions: McGoon index (cutoff value, 1.31) and PAI (cutoff value, 90) are reliable indices for predicting mortality in CDH. Pulmonary artery index appears to be more useful than MGI for predicting disease severity among survivors.

Original languageEnglish
Pages (from-to)2101-2106
Number of pages6
JournalJournal of Pediatric Surgery
Volume44
Issue number11
DOIs
Publication statusPublished - 2009 Nov
Externally publishedYes

Fingerprint

Pulmonary Artery
Mortality
Survivors
Nitric Oxide
Vasodilator Agents
Intubation
Diaphragm
Congenital Diaphragmatic Hernias
Lung Diseases
Medical Records
Hospitalization
Therapeutics
Parents
Oxygen
Lung

Keywords

  • Congenital diaphragmatic hernia
  • Disease severity
  • Echocardiography
  • McGoon index
  • Pulmonary artery index

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Evaluating mortality and disease severity in congenital diaphragmatic hernia using the McGoon and pulmonary artery indices. / Takahashi, Shigehiro; Oishi, Yoshihisa; Ito, Naoki; Nanba, Yukiko; Tsukamoto, Keiko; Nakamura, Tomoo; Ito, Yushi; Hayashi, Satoshi; Sago, Haruhiko; Kuroda, Tatsuo; Honna, Toshiro.

In: Journal of Pediatric Surgery, Vol. 44, No. 11, 11.2009, p. 2101-2106.

Research output: Contribution to journalArticle

Takahashi, S, Oishi, Y, Ito, N, Nanba, Y, Tsukamoto, K, Nakamura, T, Ito, Y, Hayashi, S, Sago, H, Kuroda, T & Honna, T 2009, 'Evaluating mortality and disease severity in congenital diaphragmatic hernia using the McGoon and pulmonary artery indices', Journal of Pediatric Surgery, vol. 44, no. 11, pp. 2101-2106. https://doi.org/10.1016/j.jpedsurg.2009.05.012
Takahashi, Shigehiro ; Oishi, Yoshihisa ; Ito, Naoki ; Nanba, Yukiko ; Tsukamoto, Keiko ; Nakamura, Tomoo ; Ito, Yushi ; Hayashi, Satoshi ; Sago, Haruhiko ; Kuroda, Tatsuo ; Honna, Toshiro. / Evaluating mortality and disease severity in congenital diaphragmatic hernia using the McGoon and pulmonary artery indices. In: Journal of Pediatric Surgery. 2009 ; Vol. 44, No. 11. pp. 2101-2106.
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AU - Takahashi, Shigehiro

AU - Oishi, Yoshihisa

AU - Ito, Naoki

AU - Nanba, Yukiko

AU - Tsukamoto, Keiko

AU - Nakamura, Tomoo

AU - Ito, Yushi

AU - Hayashi, Satoshi

AU - Sago, Haruhiko

AU - Kuroda, Tatsuo

AU - Honna, Toshiro

PY - 2009/11

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N2 - Purpose: Lung hypoplasia is associated with mortality in congenital diaphragmatic hernia (CDH). However, the association between lung hypoplasia and disease severity is unclear. Early prediction of disease severity would provide parents with more precise information about the anticipated course of treatment, minimize treatment disruption, and maximize the efficient management of patients with CDH. We aimed at identifying the relationship between McGoon index (MGI) and pulmonary artery index (PAI) scores and disease severity among infants with CDH. Methods: We retrospectively reviewed the medical records of 19 high-risk patients with CDH born between January 2006 and December 2007. McGoon index and PAI scores were determined on admission. We evaluated statistically the relationship between these scores and variables representing severity as follows: number of vasodilators, use of inhaled nitric oxide (iNO), closed method of diaphragm, duration of intubation, duration of hospitalization, and use of home oxygen therapy. Statistical significance was P < .05. Results: Overall median MGI and PAI scores were 1.40 and 108, respectively; scores for nonsurvivors were significantly (P < .05 and P < .01, respectively) lower than those for survivors. Among survivors, PAI scores were significantly (P < .05) lower in infants requiring iNO than in infants not requiring iNO and patch repair. The PAI scores were significantly correlated with the number of vasodilators (r = -0.789; P < .01) and duration of intubation (r = -0.610; P < .05). Conclusions: McGoon index (cutoff value, 1.31) and PAI (cutoff value, 90) are reliable indices for predicting mortality in CDH. Pulmonary artery index appears to be more useful than MGI for predicting disease severity among survivors.

AB - Purpose: Lung hypoplasia is associated with mortality in congenital diaphragmatic hernia (CDH). However, the association between lung hypoplasia and disease severity is unclear. Early prediction of disease severity would provide parents with more precise information about the anticipated course of treatment, minimize treatment disruption, and maximize the efficient management of patients with CDH. We aimed at identifying the relationship between McGoon index (MGI) and pulmonary artery index (PAI) scores and disease severity among infants with CDH. Methods: We retrospectively reviewed the medical records of 19 high-risk patients with CDH born between January 2006 and December 2007. McGoon index and PAI scores were determined on admission. We evaluated statistically the relationship between these scores and variables representing severity as follows: number of vasodilators, use of inhaled nitric oxide (iNO), closed method of diaphragm, duration of intubation, duration of hospitalization, and use of home oxygen therapy. Statistical significance was P < .05. Results: Overall median MGI and PAI scores were 1.40 and 108, respectively; scores for nonsurvivors were significantly (P < .05 and P < .01, respectively) lower than those for survivors. Among survivors, PAI scores were significantly (P < .05) lower in infants requiring iNO than in infants not requiring iNO and patch repair. The PAI scores were significantly correlated with the number of vasodilators (r = -0.789; P < .01) and duration of intubation (r = -0.610; P < .05). Conclusions: McGoon index (cutoff value, 1.31) and PAI (cutoff value, 90) are reliable indices for predicting mortality in CDH. Pulmonary artery index appears to be more useful than MGI for predicting disease severity among survivors.

KW - Congenital diaphragmatic hernia

KW - Disease severity

KW - Echocardiography

KW - McGoon index

KW - Pulmonary artery index

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