title: Prognostic factors related to mortality in newborns with Bochdalek hernia: a case-control study.
abstract: BACKGROUND
  Bochdalek hernia remains an entity carrying a high mortality. Because there are no published studies about prognostic factors for mortality in Bochdalek hernia in underdeveloped countries, we designed the present study. Our objective was to determine the prognostic factors related to mortality in Bochdalek hernia in countries such as Mexico.
  
  
  METHODS
  We designed a case (deceased)-control (alive) study during a 10-year period analyzing epidemiological and pre-, intra- and postoperative factors related to mortality. Our protocol is to operate when the patient is hemodynamically stable.
  
  
  RESULTS
  We analyzed 11 cases and 38 controls. There was pulmonary hypertension in 65% of the patients. Associated anomalies were not related to mortality. Low Apgar score (p = 0.016), the need for high frequency ventilation (p = 0.003) or having postoperative complications (p = 0.025) were related to mortality with pulmonary hypertension being the main cause. Odds ratios showed that immediate intubation, preoperative pulmonary hypertension (p = 0.05) and the necessity for preoperative stabilization (p = 0.043) increased mortality risk by 1.5 times. Using preoperative high-frequency ventilation increased the risk nine times and, when needed postoperatively, increases the risk 11 times.
  
  
  CONCLUSIONS
  Factors related to mortality were low Apgar score, immediate intubation, need for stabilization, postoperative complications and need for high-frequency ventilation.
authors.affiliation: Departamento de Cirugía General, Hospital Infantil de México "Federico Gómez," Secretaría de Salud, México. eduardo@fambracho.org
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bracho-Blanchet
authors.forename: Sandro
authors.initials: S
authors.lastname: Esperante-Lozano
authors.forename: Roberto
authors.initials: R
authors.lastname: Dávila-Pérez
authors.forename: Francisco
authors.initials: F
authors.lastname: Reed-López Güereña
authors.forename: Cristian
authors.initials: C
authors.lastname: Zalles-Vidal
authors.forename: Jaime
authors.initials: J
authors.lastname: Nieto-Zermeño
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006548:Hernia, Diaphragmatic / Q000401:mortality / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies