title: Risk stratification for congenital diaphragmatic hernia by factors within 24 h after birth.
abstract: To establish a simple risk stratification system for patients with congenital diaphragmatic hernia (CDH) based on postnatal information within 24 h after birth.
  
  
  
  A multi-institutional retrospective cohort study was conducted including 348 neonates who had isolated CDH born between 2006 and 2010. Based on the two most powerful variables for 90-day survival selected by multivariate analyses, a risk stratification system was established.
  
  
  
  Multiple logistic regression analysis identified two adverse prognostic factors: an Apgar score at 1 min (Ap1) of 0-4 (odds ratio (OR) 3.3, P=0.004), and a best oxygenation index (OI) ⩾8.0 (OR 11.4, P<0.001). Based on a combinations of these two factors, patients were classified into three risk categories. The 90-day survival rates in categories 1-3 were 100, 88 and 52%, respectively (P<0.001).
  
  
  
  Our simple risk stratification system based on Ap1 and best OI was capable of predicting mortality well.
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Terui
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nagata
authors.affiliation: Division of Surgery, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kanamori
authors.affiliation: Department of Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
authors.forename: M
authors.identifier: 0000-0001-5217-3219
authors.initials: M
authors.lastname: Hayakawa
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Okuyama
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Inamura
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Taguchi
authors.affiliation: Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Usui
mesh_terms: D001034:Apgar Score; D001784:Blood Gas Analysis; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D013997:Time Factors