Congenital Diaphragmatic Hernia: Co-Morbidities and Predictor of Mortality in Aseer Region, Southwestern Saudi Arabia
Mohamed, W., Al-Shehri, M., Al-Malki, T. (2004). Congenital Diaphragmatic Hernia: Co-Morbidities and Predictor of Mortality in Aseer Region, Southwestern Saudi Arabia. EKB Journal Management System, 34(3), 565-574. doi: 10.21608/jhiph.2004.186882
Walid A. Mohamed; Mohamed A. Al-Shehri; Talal Al-Malki. "Congenital Diaphragmatic Hernia: Co-Morbidities and Predictor of Mortality in Aseer Region, Southwestern Saudi Arabia". EKB Journal Management System, 34, 3, 2004, 565-574. doi: 10.21608/jhiph.2004.186882
Mohamed, W., Al-Shehri, M., Al-Malki, T. (2004). 'Congenital Diaphragmatic Hernia: Co-Morbidities and Predictor of Mortality in Aseer Region, Southwestern Saudi Arabia', EKB Journal Management System, 34(3), pp. 565-574. doi: 10.21608/jhiph.2004.186882
Mohamed, W., Al-Shehri, M., Al-Malki, T. Congenital Diaphragmatic Hernia: Co-Morbidities and Predictor of Mortality in Aseer Region, Southwestern Saudi Arabia. EKB Journal Management System, 2004; 34(3): 565-574. doi: 10.21608/jhiph.2004.186882

Congenital Diaphragmatic Hernia: Co-Morbidities and Predictor of Mortality in Aseer Region, Southwestern Saudi Arabia

Journal of High Institute of Public Health
Article 6, Volume 34, Issue 3, July 2004, Page 565-574  XML
Document Type: Original Article
DOI: 10.21608/jhiph.2004.186882
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Authors
Walid A. Mohamed1; Mohamed A. Al-Shehri1; Talal Al-Malki2
1Department of Pediatrics, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
2Department of Pediatrics Surgery, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
Abstract
Background: Congenital diaphragmatic hernia [CDH] is a life-threatening anomaly with a significant infant mortality rate. Few parameters have been well defined to aid in prediction of outcome of these infants.
Objectives: This study was designed to report the characteristics of infants with congenital diaphragmatic hernia and their outcomes in relation to clinical, laboratory, and surgical findings.
Methods: A 10 year retrospective cohort study of newborn infants with CDH in Aseer region was conducted.
Results: A total of 21 cases of CDH were identified, male: female ratio was 1.6:1, 18 cases [86%] were left sided, 52% and 38% had low Apgar scores at 1 and 5 minutes, respectively, and 43% required high peak inspiratory pressure [>24cm H2O]. Initial blood gases done at the time of presentation showed acidosis [38%], hypoxia [71%], and hypercapnia [57%]. Associated anomalies were detected in 43% of cases in the form of congenital heart, gastrointestinal, and others. Stomach and viscera were present in the chest cavity of 38% and 33% of cases, respectively. Early surgical repair [<36 hours] was done for 33% of cases. Of all cases, 10 died, with a case fatality rate of 48%. Significant predictors of mortality were; hypercapnia [RR=6.75, 95% CI: 1.03-44.08], requirement of high peak inspiratory pressure [RR= 3.5, 95% CI: 1.27-9.65], and persistent pulmonary hypertension [RR= 2.13, 95% CI: 1.00-4.61].
Conclusion: Respiratory parameters such as arterial blood gases values, respiratory system compliance, ventilator settings, and respiratory complications may predict the outcome of infants with CDH.      
Keywords
Congenital Diaphragmatic Hernia; Co-Morbidities; Predictor of Mortality; Aseer Region; Saudi Arabia
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