A preoperative x-ray scoring system for risk assessment of newborns with congenital diaphragmatic hernia.
The survival rate for newborn infants with congenital diaphragmatic hernia (CDH) is about 50%. The preoperative x-rays of 34 babies with CDH, presenting during the first 12 hours of life were reviewed to determine whether or not the 16 survivors (47%) might be identified. A scoring system using five roentgen findings having a significant correlation with survival (side of diaphragmatic hernia, location of stomach, presence of pneumothorax, relative volume of aerated ipsilateral and contralateral lung) were summed to obtain a total x-ray score. Cumulative scores ranged from 2 to 9 with 4 of 16 survivors (25%) and 16 of 18 (89%) non-survivors scoring above 6. Twelve of 16 (75%) survivors and 2 of 18 non-survivors (11%) (P less than 0.005), scored 6 or less. Individual x-ray findings were less specific in predicting outcome than the total score. Careful examination of the preoperative chest x-ray may give the surgeon an additional method for predicting outcome following repair of CDH during the first 12 hours of life.
D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging / Q000401:mortality; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D011300:Preoperative Care; D011379:Prognosis; D011859:Radiography; D012306:Risk