title: Predictive outcome indexes in neonatal Congenital Diaphragmatic Hernia.
abstract: OBJECTIVE
  We examined the reliability of the main prenatal and postnatal prognosis-related indexes that can be used to evaluate congenital diaphragmatic hernia (CDH) outcome.
  
  
  METHODS
  Seventy-seven neonates with CDH were analyzed according to CDH prognosis-related factors, divided into prenatal findings, postnatal clinical values and postnatal predictive outcome scores applied at birth and within the first 12-24 h. The data are compared between two groups: survivors and non-survivors.
  
  
  RESULTS
  During prenatal age, major associated anomalies, intrathoracic stomach, diagnosis prior to 25 weeks of gestational age and lung-to-head ratio < 0.6 were statistically significant, demonstrating their greater incidence in non-survivors. The majority of postnatal values at PICU admission were found to be reliable in identifying the CDH outcome: paO2/FiO2, oxygenation index, alveolar-arterial-O2 gradient, arterial-alveolar-O2 tension ratio, pH, mean blood pressure, body temperature. All the postnatal predictive outcome scores (Apgar 1' and 5', CDH-Study-Group equation, Score for Neonatal-Acute-Physiology II, SNAP-Perinatal-Extension II, Pediatric Risk of Mortality III and Wilford-Hall/Santa-Rosa formula) were statistically significant with more favorable values for prognosis in the survivors group.
  
  
  CONCLUSIONS
  The chances of predicting CDH outcome are fairly high. During prenatal age, only a few findings may be obtained. Conversely, many postnatal indexes and scores can reliably predict such outcome.
authors.affiliation: a Department of Paediatric Anaesthesia and Intensive Care .
authors.forename: A
authors.initials: A
authors.lastname: Gentili
authors.forename: L
authors.initials: L
authors.lastname: Pasini
authors.forename: E
authors.initials: E
authors.lastname: Iannella
authors.forename: V
authors.initials: V
authors.lastname: Landuzzi
authors.forename: M
authors.initials: M
authors.lastname: Lima
authors.forename: M L
authors.initials: ML
authors.lastname: Bacchi Reggiani
authors.forename: S
authors.initials: S
authors.lastname: Baroncini
mesh_terms: D001784:Blood Gas Analysis; D005260:Female; D005865:Gestational Age; D006305:Health Status Indicators; D065630:Hernias, Diaphragmatic, Congenital / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011296:Prenatal Diagnosis / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results
keywords: Congenital diaphragmatic hernia; neonate; outcome predictive indexes; postnatal scores; prenatal findings; survival