Table 3 Unadjusted associations for composite outcome of survival without receiving ECMO among infants with CDH.

From: Congenital diaphragmatic hernia outcomes: navigating center-to-center variability in level 4 NICUs in the Children’s Hospitals Neonatal Consortium

Variable(s)

Died or Received ECMO

Survived w/o ECMO

OR 95% CI

p

N (%)

1334

2305

  

Gestational age at birth < 35 weeks

168 (12.6)

231 (10)

0.77 (0.63, 0.95)

0.017

Female Sex (N, %)

597 (44.8)

886 (38.4)

0.77 (0.67, 0.88)

<0.001

SGA < 10th centile (n, %)

212 (15.9)

238 (10.3)

0.61 (0.5, 0.74)

<0.001

5 min Apgar < 3 (n, %)

119 (8.9)

53 (2.3)

0.24 (0.17, 0.33)

<0.001

Any BSI (n, %)

192 (14.4)

152 (6.6)

0.42(0.34, 0.53)

<0.001

Birth Year

   

<0.001

 2010–2013

366 (27.4)

470 (20.4)

referent

.

 2014–2016

327 (24.5)

482 (20.9)

1.15 (0.94, 1.4)

0.168

 2017–2019

336 (25.2)

691 (30)

1.6 (1.33, 1.93)

<0.001

 2020–2023

305 (22.9)

662 (28.7)

1.69 (1.39, 2.05)

<0.001

Antenatal diagnosis (n, %)

1076 (80.7)

1464 (63.5)

0.42 (0.36, 0.49)

<0.001

Pre-repair pneumothorax (n, %)

179 (13.4)

54 (2.3)

0.15 (0.11, 0.21)

<0.001

Congenital heart disease (CHD)

    

 ASD/VSD

245 (18.4)

347 (15.1)

0.73 (0.61, 0.88)

0.001

 Other CHD

110 (8.2)

63 (2.7)

0.3 (0.22, 0.41)

<0.001

 None

979 (73.4)

1895 (82.2)

referent

-

ASD (n, %)

126 (9.4)

221 (9.6)

1.02 (0.81, 1.28)

0.888

VSD (n, %)

153 (11.5)

183 (7.9)

0.67 (0.53, 0.83)

<0.001

Either ASD OR VSD or AVSD (n, %)

247 (18.5)

347 (15.1)

0.78 (0.65, 0.93)

0.070

Lowest pH in first 12 h after admission

7.1 [7,7.3]

7.3 [7.2,7.4]

 

-

 <7.0

282 (21.1)

64 (2.8)

referent

-

 7.0–7.19

467 (35)

402 (17.4)

3.79 (2.8, 5.13)

<0.001

 7.2–7.29

269 (20.2)

589 (25.6)

9.65 (7.1, 13.12)

<0.001

 7.3–7.45

184 (13.8)

886 (38.4)

21.22 (15.49, 29.05)

<0.001

 >7.45+

24 (1.8)

86 (3.7)

15.79 (9.32, 26.76)

<0.001

Thoracic liver position (n, %)

862 (64.6)

918 (39.8)

0.36 (0.32, 0.42)

<0.001

Median age at referral (days, 25–75th %ile)

1 [1,1]

1 [1,2]

1.2(1.1, 1.3)

0.001

Median maximum PCO2 in first 12 h after referral (25–75th %ile)

68.3 [52, 90]

49 [40.8,61]

 

-

 PCO2 < 60 mmHg

467 (35)

1455 (63.1)

4.12 (3.54, 4.79)

<0.001

ECMO (n, %)

950 (71.2)

 

0 (0, 3.273474E153)

0.920

Left-sided CDH

985 (73.8)

1761 (76.4)

1.27 (1.07, 1.5)

0.006

Primary CDH repair (n, %)

164 (12.3)

1184 (51.4)

5.46 (4.51, 6.61)

<0.001

Median birthweight (g, 25–75th %ile)

2915 [2500, 3270]

3080 [2676, 3440]

1(1,1.1)

<0.001

Race/ethnicity (n, %)

    

 non-Hispanic White

697 (52.2)

1272 (55.2)

referent

<0.001

 non-Hispanic Black

233 (17.5)

222 (9.6)

0.52 (0.43, 0.64)

<0.001

 non-Hispanic Other

100 (7.5)

204 (8.9)

1.12 (0.86, 1.44)

0.395

 Hispanic ethnicity

237 (17.8)

474 (20.6)

1.1 (0.91, 1.31)

0.322

Post-natal drug withdrawal (n, %)

219 (16.4)

294 (12.8)

0.74 (0.62, 0.9)

0.002

Neurologic diagnoses (n, %)

139 (10.4)

61 (2.6)

0.23 (0.17, 0.32)

<0.001

Genetic/chromosomal diagnoses (n, %)

85 (6.4)

85 (3.7)

0.56 (0.41, 0.77)

<0.001

Kidney Failure (n, %)

179 (13.4)

31 (1.3)

0.09 (0.06, 0.13)

<0.001

Congenital pulmonary abnormalities (non-CDH), (n, %)

22 (1.6)

14 (0.6)

0.36 (0.19, 0.71)

0.003

Airway Malacia (n, %)

71 (5.3)

79 (3.4)

0.63 (0.45, 0.88)

0.006

Gastrointestinal Disorders (n, %)

102 (7.6)

166 (7.2)

0.94 (0.73, 1.21)

0.618

  1. SGA criteria based on Olsen et al.11.
  2. BSI blood stream infection, culture positive only, ASD atrial septal defect, VSD ventricular septal defect, AVSD atrioventricular septal defect, ECMO extracorporeal support.
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