Long Term Outcomes in CDH: Cardiopulmonary Outcomes and Health Related Quality of Life
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Read the article on jpedsurg.org ↗Article · Apr 2022 · 1 min read
In brief
In brief
Systematic review of 65 studies examining long-term cardiopulmonary outcomes in congenital diaphragmatic hernia (CDH) survivors reveals persistent morbidity including variable pulmonary hypertension rates (4.5-38%), abnormal lung function, and reduced quality of life. Authors advocate for dedicated multidisciplinary follow-up clinics to support CDH survivors transitioning to adulthood.
Written by the GCMD Library team from the article.
Background
With improvements in clinical management and an increase in CDH survivorship there is a crucial need for better understanding of long-term health outcomes in CDH.
Aim
To investigate the prevalence of cardiopulmonary health morbidity and health related quality of life (HRQoL) in CDH survivors.
Methods
We included all studies (n=65) investigating long-term cardiopulmonary outcomes in CDH patients over 2 years published in the last 30 years. The Newcastle-Ottawa Scale and the CASP checklist for cohort studies were utilised to assess study quality. Results were reported descriptively and collated by age group where possible.
Results
The incidence of pulmonary hypertension was highly variable (4.5-38%), though rates (%) appeared to diminish after 5 years of age. Lung function indices and radiological outcomes were frequently abnormal, and Health Related Quality of Life (HRQoL) reduced also. Long term diseases notably emphysema and COPD are not yet fully described in the contemporary literature.
Conclusion
This study underscores cardiopulmonary health morbidity and a reduced HRQoL amongst CDH survivors. Where not already available dedicated multidisciplinary follow-up clinics should be established to support these vulnerable patients transition safely into adulthood. Future research is therefore needed to investigate the risk factors for cardiopulmonary ill health and morbidity in CDH survivors.
Level of Evidence
Level III