Background Congenital diaphragmatic hernia (CDH) is a rare birth defect with substantial mortality. This study aims to generate a population-based overview of CDH care and outcomes in the Netherlands. Moreover, it assesses interhospital variations between the two Dutch CDH expert centres. Methods This study uses data from the Dutch branch of the European Pediatric Surgical Audit, a prospective clinical audit for congenital anomalies. Data of all patients with CDH treated between 2014 and 2021 were included for epidemiological analysis. For comparative analyses, patients presenting after the neonatal period or not treated in the two CDH expert centres were excluded. Identified interhospital variations were assessed using regression analysis. Results In the study period, 283 children with CDH were born, resulting in a national prevalence rate of 2.06/10 000 live births. The patient population, treatment and outcomes at 1 year were comparable between the hospitals, except for length of hospital stay. Regression analysis identified the treating hospital as the strongest significant predictor thereof. Other factors associated with longer length of stay include the presence of other malformations, intrathoracic liver position on prenatal ultrasound, extracorporeal membrane oxygenation treatment, patch repair, complicated postoperative course and discharge to home rather than to another care facility. Conclusion Outcomes of CDH care throughout the Netherlands are comparable. However, the length of stay differed between the two hospitals, also when adjusting for other covariates. Further qualitative analysis to explain this interhospital variation is indicated. Our findings underscore the potential of clinical auditing as a quality measurement tool in rare conditions. Data may be obtained from a third party and are not publicly available. Upon request, the study protocol, EPSA’s data dictionary and statistical code used for analyses in this manuscript are available from the corresponding author at n.teunissen@erasmusmc.nl.

中文翻译：

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荷兰先天性膈疝的患病率和早期手术结果：欧洲儿科外科审计的一项基于人群的队列研究

背景 先天性膈疝（CDH）是一种罕见的出生缺陷，死亡率很高。本研究旨在对荷兰 CDH 护理和结果进行基于人群的概述。此外，它还评估了两个荷兰 CDH 专家中心之间的医院间差异。方法本研究使用欧洲儿科外科审计荷兰分会的数据，这是一项针对先天异常的前瞻性临床审计。2014 年至 2021 年间所有接受治疗的 CDH 患者的数据均纳入流行病学分析。为了进行比较分析，排除了新生儿期后就诊或未在两个 CDH 专家中心接受治疗的患者。使用回归分析评估已确定的医院间差异。结果 研究期间，出生CDH患儿283例，全国活产儿患病率为2.06/1万。除住院时间外，各医院的患者人数、治疗和 1 年结果具有可比性。回归分析确定治疗医院是其最强的显着预测因素。与较长住院时间相关的其他因素包括存在其他畸形、产前超声显示的胸腔内肝脏位置、体外膜氧合治疗、补片修复、复杂的术后病程以及出院回家而不是到其他护理机构。结论 整个荷兰的 CDH 护理结果具有可比性。然而，在调整其他协变量时，两家医院的住院时间也有所不同。指出了进一步的定性分析来解释这种医院间差异。我们的研究结果强调了临床审核作为罕见情况下的质量测量工具的潜力。数据可能从第三方获得，并且不公开。根据要求，本手稿中用于分析的研究方案、EPSA 数据字典和统计代码可从通讯作者 n.teunissen@erasmusmc.nl 处获取。