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

研究成果: Article査読

10 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)2101-2106
ページ数6
ジャーナルJournal of Pediatric Surgery
44
11
DOI
出版ステータスPublished - 2009 11 1
外部発表はい

ASJC Scopus subject areas

  • 外科
  • 小児科学、周産期医学および子どもの健康

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