Comparison of CDHSG model and PCO2 in predicting mortality risk in patients with congenital diaphragmatic hernia

Abstract

Congenital diaphragmatic hernia (CDH) is one of the illnesses with high mortality and morbidity rates. The study aims to compare the Congenital Diaphragmatic Hernia Study Group (CDHSG) model and PCO₂ in determining the mortality risk of CDH in the early postnatal period in neonates. The data of 35 patients who were treated CDH were analyzed retrospectively. The sex, gestational age, birth weight, delivery method, presence of chromosomal anomaly, congenital cardiac and other anomalies, pulmonary hypertension, the 5-min Apgar score, PCO₂ values of blood gas in the first 24 h, mode of ventilation were recorded. According to the CDHSG model, the mortality risk of CDH was divided into three categories: as low, moderate, high risk. Based on the blood gases in the first 24 h after delivery, the CDH mortality risk was considered in two categories as low and high. Based on the CDHSG model, the risk of CDH mortality was low in 11.4%, moderate in 20%, and high in 68.6%. Mortality rates were 0%, 42.8%, and 83.3%, respectively. Based on the PaCO₂, the risk of CDH mortality was low in 37.1% of patients and high in 62.8%. The mortality rate was 86.3% in high-severity patients and 30.7% in low-risk patients. No significant difference was found between the area under the curve values of the CDHSG model and PCO₂. Especially in developing countries, in cases where opportunities are limited, the severity of the disease, the need for more aggressive treatment, and the need for higher-level intensive care can be determined with the easily accessible and low-cost blood gas PCO₂ at the bedside.