Surgical outcomes associated with delayed presentation of congenital diaphragmatic hernia: A national analysis of pediatric patients

IF 2.3 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2026-12-01 Epub Date: 2026-10-13 DOI:10.1016/j.amjsurg.2026.117302

Cameron J. Harvey, Mason Caldwell, Philip M. Lee, Eden Ines, Sidney Johnson, Benjamin Tabak, Devin Puapong, Russell K. Woo

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引用次数: 0

Abstract

Background

The literature evaluating surgical outcomes of delayed presentation of congenital diaphragmatic hernia (CDH) in pediatric patients is limited. This study aims to evaluate the clinical outcomes associated with CDH repair in delayed presentations using a national database.

Methods

This retrospective cohort study utilized the Pediatric National Surgical Quality Improvement Program- Pediatrics (NSQIP-P) database to evaluate pediatric patients admitted after 28 days of life who underwent surgical management for CDH from 2014 to 2023. Age groups were further divided into infants (28 days-1 year), early childhood (1-5 years), middle childhood (6-10 years), and adolescents (11-18 years).

Results

There were 1914 pediatric patients included with 61% being male. The overall mortality rate over a 10-year period was 0.6% and did not vary between groups. Incidence of pre-operative cardiopulmonary risk factors decreased with age while gastrointestinal abnormalities were more common among older children. The overall complication rate was 10% and complications were highest among infants (13.3%) and middle childhood (13%).

Conclusion

Understanding the temporal relationship between CDH presentation, comorbidities, and outcomes may help in patient counseling, optimization, and outcome improvement.

查看原文本刊更多论文

手术结果与先天性膈疝延迟表现相关：一项全国儿科患者分析。

背景：评价小儿先天性膈疝延迟表现的手术结果的文献是有限的。本研究旨在利用国家数据库评估与迟发性表现CDH修复相关的临床结果。方法：本回顾性队列研究利用儿科国家外科质量改进计划-儿科学（NSQIP-P）数据库对2014年至2023年因CDH接受手术治疗的28天后入院的儿科患者进行评估。年龄组进一步分为婴儿（28天-1岁）、幼儿（1-5岁）、中期（6-10岁）和青少年（11-18岁）。结果：纳入1914例儿童患者，其中61%为男性。10年期间的总死亡率为0.6%，各组之间没有差异。术前心肺危险因素的发生率随着年龄的增长而下降，而胃肠道异常在年龄较大的儿童中更为常见。总并发症发生率为10%，其中婴儿（13.3%）和儿童中期（13%）并发症发生率最高。结论：了解CDH表现、合并症和预后之间的时间关系可能有助于患者咨询、优化和改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.