Variation Across Centers in Standardized Mortality Ratios for Congenital Diaphragmatic Hernia Receiving Extracorporeal Life Support

Multi-center analysis of 4,223 CDH neonates on ECLS reveals significant outcome variation: 12% of centers achieved mortality rates 16-48% below expected, while 6% had rates 25-43% above expected after risk adjustment. Lower-mortality centers showed fewer renal/infectious complications and different timing of repair, suggesting targetable quality improvement opportunities.