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Objective To explore the value of multiple ultrasound indicators in the prognosis evaluation of congenital diaphragmatic hernia and provide scientific rationales for an accurate diagnosis and treatment of congenital diaphragmatic hernia (CDH). Methods From January 2018 to December 2022, preoperative ultrasonic images were retrospectively reviewed for 92 CDH children undergoing neonatal surgery. The relevant indicators included length of diaphragmatic defect (≤4 cm & >4 cm), location of liver (liver hernia & non liver hernia) and gastric vesicles (left/right), hernia sac (yes or no) and whether or not lung ultrasound was abnormal. According to their prognosis, they were divided into two groups of death and survival. And the relationship between each indicator and the prognosis of children (death or survival) was statistically examined. Results Among them, 70 survived and 22 died with a case fatality rate of 23.9%. Comparing survival group with death group, the difference in the proportion of herniation into liver [(25.7% (18/70) vs. 54.5% (12/22)], presence of hernial sacs [survival group: 72.9% (51/70), death group: 50.0% (11/22)] and presence of ultra sonographic abnormality in lungs [survival group: 48.6% (34/70), death group: 81.8% (18/22)] were statistically significant (all P < 0.05 ) . Multivariate Logistic regression analysis indicated that diaphragmatic defect length >4 cm OR = 4.513, 95% * CI / 1.12 18.184 ), liver herniation into chest OR = 3.636, 95% * CI / 1.171 11.29 ), lung ultrasonic abnormalities OR = 3.64, 95% * CI / 1.022 12.963 ) and an absence of hernia sac (OR = 3.428,95% CI:1.066-11.025) were risk factors for a poor prognosis of CDH. Kappa values for diaphragmatic defect length >4 cm, liver herniation into chest, absence of hernia sac and lung ultrasonic abnormalities were <0.6 whereas Kappa value for a combination of these four parameters was 0.788. Conclusions Diaphragmatic defect length, liver location, hernia sac and lung function may be employed as prognostic indicators for CDH children. And a combination of the above four parameters can more accurately predict the outcomes of CDH children. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Pediatric Surgery is the property of Journal of Clinical Pediatric Surgery Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Pediatric Surgery is the property of Journal of Clinical Pediatric Surgery Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)