title: Prognostic factors of gastroesophageal reflux disease in congenital diaphragmatic hernia: a multicenter study.
abstract: OBJECTIVE
  Gastroesophageal reflux disease (GERD) is one of the concomitant problems in infants with congenital diaphragmatic hernia (CDH). We assessed risk factors of GERD in CDH patients.
  
  
  METHODS
  The retrospective observational study for CDH infants was conducted. Cases of CDH who were born between January 2006 and December 2010, were operated in the 9 participating institutions, and survived to discharge were included. Completion of medical therapy for GERD and incidence of surgery were primary outcomes. Kaplan-Meier survival analysis and Cox proportional hazards regression were used.
  
  
  RESULTS
  In 182 cases of CDH, the medical therapies for GERD were performed in 23.8% (40/168), and were completed in 60.0% (24/40). Prenatal detection of CDH (HR 5.87, CI 1.6-18.8, p = 0.012) and tube feeding at discharge (HR 5.04, 95% CI 1.3-33.1, p = 0.016) were significantly correlated with unsuccessful weaning from medical therapy. Surgery for GERD was performed in 10.7% (18/169). Gestational age (HR 4.78, 95% CI 1.5-21.1, p = 0.006) and diaphragmatic defect of more than 75% (HR 4.3, 95% CI 1.6-12.9, p = 0.005) were significantly correlated with need for antireflux surgery.
  
  
  CONCLUSIONS
  Diaphragmatic defect of more than 75% was risk factor of future need for antireflux surgery.
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8677, Japan, kta@cc.rim.or.jp.
authors.forename: Keita
authors.initials: K
authors.lastname: Terui
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Taguchi
authors.forename: Keiji
authors.initials: K
authors.lastname: Goishi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tazuke
authors.forename: Akiko
authors.initials: A
authors.lastname: Yokoi
authors.forename: Hajime
authors.initials: H
authors.lastname: Takayasu
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Okuyama
authors.forename: Hideo
authors.initials: H
authors.lastname: Yoshida
authors.forename: Noriaki
authors.initials: N
authors.lastname: Usui
mesh_terms: D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index