title: Influence of congenital heart disease on survival in children with congenital diaphragmatic hernia.
abstract: OBJECTIVE
  We sought to assess outcome in patients with CDH and HD to determine if LHR is also predictive of outcome in this subset of patients.
  
  
  METHODS
  We carried out a retrospective review (April 1996-October 2000) of patients with isolated CDH (n = 143, 82.2%) and patients with HD (n = 31, 17.8%) to determine the incidence of additional anomalies, survival to term, CDH repair, cardiac repair, and survival to discharge. Survival based on LHR was analyzed in a subset of fetuses.
  
  
  RESULTS
  The risk of death from birth to last follow-up was 2.9 times higher for patients with CDH plus HD than for patients with CDH alone (P <.0001). Of 11 patients with CDH plus HD who had CDH repair (5 of whom also had HD repair), 5 survived. All 10 patients with an LHR <1.2 died; 3 of 6 with an LHR >1.2 survived (Fisher exact test, P =.04).
  
  
  CONCLUSIONS
  Heart disease remains a significant risk factor for death in infants with CDH. The LHR helps predict survival in this high-risk group of patients.
authors.affiliation: Cardiac Center and The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
authors.forename: Meryl S
authors.initials: MS
authors.lastname: Cohen
authors.forename: Jack
authors.initials: J
authors.lastname: Rychik
authors.forename: David M
authors.initials: DM
authors.lastname: Bush
authors.forename: Zhi-Yun
authors.initials: ZY
authors.lastname: Tian
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Howell
authors.forename: N Scott
authors.initials: NS
authors.lastname: Adzick
authors.forename: Alan W
authors.initials: AW
authors.lastname: Flake
authors.forename: Mark P
authors.initials: MP
authors.lastname: Johnson
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Spray
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Crombleholme
mesh_terms: D000015:Abnormalities, Multiple / Q000401:mortality*; D005260:Female; D006330:Heart Defects, Congenital; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging / Q000401:mortality*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000473:pathology; D010414:Pennsylvania / Q000453:epidemiology; D011247:Pregnancy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D015996:Survival Rate; D016216:Ultrasonography, Prenatal