title: Survival disparities in newborns with congenital diaphragmatic hernia: a national perspective.
abstract: OBJECTIVE
  The aim of the study was to examine national outcomes for congenital diaphragmatic hernia (CDH).
  
  
  METHODS
  We analyzed the Kids' Inpatient Database for patients admitted at less than 8 days of age.
  
  
  RESULTS
  Overall, 2774 hospitalizations were identified. Most patients were white and had private insurance. Most patients were treated at urban (96%), teaching (75%), and not identified as children's hospital (NIACH) (50%). Birth was the most common admission source at NIACH (91%) and children's unit in general hospital (CUGH) (59%), compared to hospital transfer at children's general hospital (CGH) (81%). Most CDH were repaired through the abdomen (81%), and 25% required extracorporeal membrane oxygenation (ECMO). Most NIACH patients were transferred to another hospital, whereas most at CGH and CUGH were discharged home. Survival to discharge was 66% after excluding hospital transfers. Univariate analysis revealed higher survival for males, birth weight (BW) of 3 kg or more, whites, patients with private insurance, and those in the highest median household income quartile. Survival was 86% after CDH repair but 46% for ECMO. Multivariate analysis identified black race (hazard ratio [HR], 1.536; P = .03) and other race (HR, 1.515; P = .03) as independent predictors of mortality.
  
  
  CONCLUSIONS
  Hospital survival for CDH is related to sex, BW, race, and socioeconomic status. Blacks and other non-Hispanic minorities have higher mortality rates.
authors.affiliation: Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery University of Miami Miller School of Medicine, Miami, FL 33136, USA. jsola@med.miami.edu
authors.forename: Juan E
authors.initials: JE
authors.lastname: Sola
authors.forename: Steven N
authors.initials: SN
authors.lastname: Bronson
authors.forename: Michael C
authors.initials: MC
authors.lastname: Cheung
authors.forename: Beatriz
authors.initials: B
authors.lastname: Ordonez
authors.forename: Holly L
authors.initials: HL
authors.lastname: Neville
authors.forename: Leonidas G
authors.initials: LG
authors.lastname: Koniaris
mesh_terms: D005260:Female; D006548:Hernia, Diaphragmatic / Q000401:mortality* / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology