TY  - JOUR
A1  - Wittekindt, Boris
A1  - Gfrörer, Stefan
A1  - Doberschütz, Nora Patricia
A1  - Schmedding, Andrea
A1  - Theilen, Till-Martin
A1  - Schlößer, Rolf
A1  - Rolle, Udo
T1  - Epidemiology and one-year follow-up of neonates with CDH-data from health insurance claims in Germany
T2  - Children
N2  - Congenital diaphragmatic hernia (CDH) is a major congenital malformation with high mortality. Outcome data on larger unselected patient groups in Germany are unavailable as there is no registry for CDH. Therefore, routine data from the largest German health insurance fund were analyzed for the years 2009–2013. Main outcome measures were incidence, survival and length of hospital stay. Follow-up was 12 months. 285 patients were included. The incidence of CDH was 2.73 per 10,000 live births. Overall mortality was 30.2%. A total of 72.1% of the fatalities occurred before surgery. Highest mortality (64%) was noted in patients who were admitted to specialized care later as the first day of life. Patients receiving surgical repair had a better prognosis (mortality: 10.8%). A total of 67 patients (23.5%) were treated with ECMO with a mortality of 41.8%. The median cumulative hospital stay among one-year survivors was 40 days and differed between ECMO- and non-ECMO-treated patients (91 vs. 32.5 days, p < 0.001). This is the largest German cohort study of CDH patients with a one-year follow-up. The ECMO subgroup showed a higher mortality. Another important finding is that delayed treatment in specialized care increases mortality. Prospective clinical registries are needed to elucidate the treatment outcomes in detail.
KW  - congenital diaphragmatic hernia
KW  - mortality
KW  - ECMO
KW  - insurance data
KW  - follow-up
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/60943
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-609436
SN  - 2227-9067
N1  - Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).
VL  - 8
IS  - 2, art. 160
SP  - 1
EP  - 9
PB  - MDPI
CY  - Basel
ER  -