title: The congenital diaphragmatic hernia composite prognostic index correlates with survival in left-sided congenital diaphragmatic hernia.
abstract: OBJECTIVE
  We developed the congenital diaphragmatic hernia congenital prognostic index (CDH-CPI) to incorporate all known prognostic variables into a single composite index to improve prognostic accuracy. The purpose of this study is to examine the ability of the CDH-CPI to predict survival in patients with left-sided congenital diaphragmatic hernia and to determine if the index has a stronger correlation with survival than each of the individual components.
  
  
  METHODS
  A retrospective review of patients with left-sided congenital diaphragmatic hernia between 2004 and 2010 was conducted. Ten prenatal parameters of the CDH-CPI were collected, total score was tabulated, and patients stratified according to total score and survival.
  
  
  RESULTS
  Sixty-four patients with a prenatal diagnosis of left-sided congenital diaphragmatic hernia were identified. Patients with a CDH-CPI score of 8 or higher had a significantly higher survival than patients with a CDH-CPI score of lower than 8. The CDH-CPI has the strongest correlation with survival compared with the individual parameters measured. The CDH-CPI correlates with extracorporeal membrane oxygenation use, and 75% of patients with a score of 5 or lower were placed on extracorporeal membrane oxygenation.
  
  
  CONCLUSIONS
  The CDH-CPI accurately stratifies survival in left-sided congenital diaphragmatic hernia. The amalgamation of 10 prenatal parameters of the CDH-CPI may be a better prenatal predictor than any single prognostic variable currently used.
authors.affiliation: The Fetal Care Center of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45267, USA.
authors.forename: Louis D
authors.initials: LD
authors.lastname: Le
authors.forename: Sundeep G
authors.initials: SG
authors.lastname: Keswani
authors.forename: Jacek
authors.initials: J
authors.lastname: Biesiada
authors.forename: Foong-Yen
authors.initials: FY
authors.lastname: Lim
authors.forename: Paul S
authors.initials: PS
authors.lastname: Kingma
authors.forename: Beth E
authors.initials: BE
authors.lastname: Haberman
authors.forename: Jason
authors.initials: J
authors.lastname: Frischer
authors.forename: Mounira
authors.initials: M
authors.lastname: Habli
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Crombleholme
mesh_terms: D006548:Hernia, Diaphragmatic / Q000145:classification / Q000150:complications / Q000401:mortality / Q000473:pathology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate