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Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany

Congenital diaphragmatic hernia (CDH) is a major congenital malformation with high mortality. Outcome data on larger unselected patient groups in Germany are unavailable as there is no registry for CDH. Therefore, routine data from the largest German health insurance fund were analyzed for the years...

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Autores principales: Wittekindt, Boris, Doberschuetz, Nora, Schmedding, Andrea, Theilen, Till-Martin, Schloesser, Rolf, Gfroerer, Stefan, Rolle, Udo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924040/
https://www.ncbi.nlm.nih.gov/pubmed/33672568
http://dx.doi.org/10.3390/children8020160
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author Wittekindt, Boris
Doberschuetz, Nora
Schmedding, Andrea
Theilen, Till-Martin
Schloesser, Rolf
Gfroerer, Stefan
Rolle, Udo
author_facet Wittekindt, Boris
Doberschuetz, Nora
Schmedding, Andrea
Theilen, Till-Martin
Schloesser, Rolf
Gfroerer, Stefan
Rolle, Udo
author_sort Wittekindt, Boris
collection PubMed
description Congenital diaphragmatic hernia (CDH) is a major congenital malformation with high mortality. Outcome data on larger unselected patient groups in Germany are unavailable as there is no registry for CDH. Therefore, routine data from the largest German health insurance fund were analyzed for the years 2009–2013. Main outcome measures were incidence, survival and length of hospital stay. Follow-up was 12 months. 285 patients were included. The incidence of CDH was 2.73 per 10,000 live births. Overall mortality was 30.2%. A total of 72.1% of the fatalities occurred before surgery. Highest mortality (64%) was noted in patients who were admitted to specialized care later as the first day of life. Patients receiving surgical repair had a better prognosis (mortality: 10.8%). A total of 67 patients (23.5%) were treated with ECMO with a mortality of 41.8%. The median cumulative hospital stay among one-year survivors was 40 days and differed between ECMO- and non-ECMO-treated patients (91 vs. 32.5 days, p < 0.001). This is the largest German cohort study of CDH patients with a one-year follow-up. The ECMO subgroup showed a higher mortality. Another important finding is that delayed treatment in specialized care increases mortality. Prospective clinical registries are needed to elucidate the treatment outcomes in detail.
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spelling pubmed-79240402021-03-03 Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany Wittekindt, Boris Doberschuetz, Nora Schmedding, Andrea Theilen, Till-Martin Schloesser, Rolf Gfroerer, Stefan Rolle, Udo Children (Basel) Article Congenital diaphragmatic hernia (CDH) is a major congenital malformation with high mortality. Outcome data on larger unselected patient groups in Germany are unavailable as there is no registry for CDH. Therefore, routine data from the largest German health insurance fund were analyzed for the years 2009–2013. Main outcome measures were incidence, survival and length of hospital stay. Follow-up was 12 months. 285 patients were included. The incidence of CDH was 2.73 per 10,000 live births. Overall mortality was 30.2%. A total of 72.1% of the fatalities occurred before surgery. Highest mortality (64%) was noted in patients who were admitted to specialized care later as the first day of life. Patients receiving surgical repair had a better prognosis (mortality: 10.8%). A total of 67 patients (23.5%) were treated with ECMO with a mortality of 41.8%. The median cumulative hospital stay among one-year survivors was 40 days and differed between ECMO- and non-ECMO-treated patients (91 vs. 32.5 days, p < 0.001). This is the largest German cohort study of CDH patients with a one-year follow-up. The ECMO subgroup showed a higher mortality. Another important finding is that delayed treatment in specialized care increases mortality. Prospective clinical registries are needed to elucidate the treatment outcomes in detail. MDPI 2021-02-20 /pmc/articles/PMC7924040/ /pubmed/33672568 http://dx.doi.org/10.3390/children8020160 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wittekindt, Boris
Doberschuetz, Nora
Schmedding, Andrea
Theilen, Till-Martin
Schloesser, Rolf
Gfroerer, Stefan
Rolle, Udo
Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany
title Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany
title_full Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany
title_fullStr Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany
title_full_unstemmed Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany
title_short Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany
title_sort epidemiology and one-year follow-up of neonates with cdh-data from health insurance claims in germany
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924040/
https://www.ncbi.nlm.nih.gov/pubmed/33672568
http://dx.doi.org/10.3390/children8020160
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