Volumen de casos en centros de tratamiento y disparidades en los resultados de los casos de Hernia Diafragmática Congénita
Topic overview
Texas statewide study (2013-2021) examining congenital diaphragmatic hernia outcomes across 93 hospitals. High-volume centers achieved lower mortality (18% vs 27%) despite treating sicker patients, while low-volume centers disproportionately served Hispanic populations along the Mexico border, revealing significant volume-outcome relationships and potential equity gaps in CDH care.
Key takeaways
- Higher-volume CDH centers (>75 cases) had lower mortality (18%) despite treating sicker patients compared to low-volume centers (27% mortality).
- Each additional CDH case treated at a center correlates with 0.5% decreased mortality odds, supporting volume-outcome relationship.
- ECMO for CDH was primarily available at high-volume centers, limiting access for patients at smaller facilities.
- Hispanic and border-region patients were disproportionately treated at low-volume centers with worse outcomes, revealing care disparities.
- Prenatal diagnosis and regionalized referral to high-volume CDH centers may improve survival for this life-threatening congenital anomaly.
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