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Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany

机译：来自德国健康保险索赔的CDH数据的新生儿流行病学和一年的跟进

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摘要

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.
机译：先天性膈疝（CDH）是具有高死亡率的主要先天性畸形。在德国较大的未选择患者组上的结果数据不可用，因为CDH没有注册管理机构。因此，来自德国最大的健康保险基金的日常数据于2009 - 2013年进行了分析。主要结果措施是发病率，存活率和住院时间。随访时间为12个月。包括285名患者。 CDH的发病率为每10,000个活产的2.73。总体死亡率为30.2％。在手术前共发生了72.1％的死亡。最高的死亡率（64％）被注意到患者在稍后作为生命的第一天录取专业护理。接受手术修复的患者具有更好的预后（死亡率：10.8％）。共有67名患者（23.5％）用ECMO治疗，死亡率为41.8％。中位累计住院住院的一年幸存者是40天，肌肉和非Ecmo治疗的患者（91例32.5天，P <0.001）之间不同。这是CDH患者的最大德国队列研究，随访一年。 ECMO亚组表现出更高的死亡率。另一个重要的发现是，专业护理的延迟治疗增加了死亡率。需要预期的临床登记，详细阐明治疗结果。

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