Epidemiology and Outcomes of Congenital Diaphragmatic Hernia in Croatia: A Population-Based Study.
Epidemiology and Outcomes of Congenital Diaphragmatic Hernia in Croatia: A Population-Based Study.
复制标题
克罗地亚先天性膈疝的流行病学和结果：基于人群的研究。
DOI：
--
复制
发表时间：
2016
影响因子：
2.8
通讯作者：
J. Sprung
中科院分区：
文献类型：
--
作者：
R. Grizelj;K. Bojanić;J. Vuković;M. Novak;U. Rodin;T. Ćorić;M. Stanojevic;D. Schroeder;T. Weingarten;J. Sprung
背景
先天性腹股沟疝（CDH）新生儿的结局是可变的;报告通常仅限于单个三级保健中心的经验，这可能是偏倚的来源。以人群为基础的研究减少了幸存者的偏见，并为这种高死亡率的情况提供了额外的见解。本研究的目的是检查克罗地亚CDH的发病率和结局。
方法
克罗地亚2001年至2013年的所有CDH病例都是从公共卫生记录中确定的。计算总体、性别和地区特异性发病率，并评估与1年生存率相关的特征。
结果
在研究期间，我们确定了145例先天性髋关节脱位，发病率为2.67/10000总出生。发病率在日历年（P = 0.38）或地理区域（P = 0.67）之间没有差异。男性的发生率略高（率比，1.37，95% CI 0.99，1.91）。整个队列的1年生存率为33.1%，在重症监护室接受任何治疗的患者的1年生存率为47.9%。多变量分析显示，左侧CDH、肝脏向上的新生儿生存率降低（比值比0.1，95% CI，0.03，0.4），在病例量较高的中心接受治疗时，生存率增加（比值比12.8，95% CI，2.2，72.1）。
结论
克罗地亚先天性心脏病的发病率在以前报告的范围内。在病例量较高的中心接受治疗的新生儿的生存率明显较高，这表明克罗地亚可能需要对CDH进行集中医疗。
BACKGROUND
Outcomes of neonates with congenital diaphragmatic hernia (CDH) are variable; reports are frequently limited to the experience of single tertiary care centres-a possible source of bias. Population-based studies decrease survivor bias and provide additional insight into this high-mortality condition. The objective of this study was to examine the incidence and outcomes of CDH in Croatia.
METHODS
All cases of CDH in Croatia from 2001 through 2013 were ascertained from public health records. Overall and sex- and region-specific incidence rates were calculated, and characteristics associated with 1-year survival were assessed.
RESULTS
We identified 145 cases of CDH during the study period, for an incidence of 2.67 per 10 000 total births. The incidence did not differ by calendar year (P = 0.38) or geographic region (P = 0.67). There was a slightly higher incidence among males (rate ratio, 1.37, 95% CI 0.99, 1.91). The 1-year survival rate was 33.1% for the entire cohort and 47.9% for liveborns who received any treatment at an intensive care unit. From multivariable analysis, survival was decreased in neonates with left CDH, liver up (odds ratio 0.1, 95% CI, 0.03, 0.4) and increased when treated in a centre with higher case volume (odds ratio 12.8, 95% CI, 2.2, 72.1).
CONCLUSIONS
The incidence of CDH in Croatia is within the range of previous reports. Survival was substantially higher in neonates treated in a centre with higher case volume, which suggests that centralisation of medical care for CDH may be warranted in Croatia.