Authors
Patrick T Delaplain, Matthew T Harting, Tim Jancelewicz, Lishi Zhang, T Yu Peter, Matteo Di Nardo, Yanjun Chen, James E Stein, Henri R Ford, Danh V Nguyen, Yigit Guner
Publication date
2019/6/1
Journal
Journal of pediatric surgery
Volume
54
Issue
6
Pages
1132-1137
Publisher
WB Saunders
Description
Purpose
Studying the timing of repair in CDH is prone to confounding factors, including variability in disease severity and management. We hypothesized that delaying repair until post-ECMO would confer a survival benefit.
Methods
Neonates who underwent CDH repair were identified within the ELSO Registry. Patients were then divided into on-ECMO versus post-ECMO repair. Patients were 1:1 matched for severity based on pre-ECMO covariates using the propensity score (PS) for the timing of repair. Outcomes examined included mortality and severe neurologic injury (SNI).
Results
After matching, 2,224 infants were included. On-ECMO repair was associated with greater than 3-fold higher odds of mortality (OR 3.41, 95% CI: 2.84–4.09, p < 0.01). The odds of SNI was also higher for on-ECMO repair (OR 1.49, 95% CI: 1.13–1.96, p < 0.01). A sensitivity analysis was performed by including the length of ECMO as an …
Scholar articles
PT Delaplain, MT Harting, T Jancelewicz, L Zhang… - Journal of pediatric surgery, 2019