Factors associated with late surgical correction of craniosynostosis: A decade-long review of the United States nationwide readmission database

• Published in: Journal of cranio-maxillo-facial surgery 2024-05, Vol.52 (5), p.585-590
• Main Authors: Habarth-Morales, Theodore E., Davis, Harrison D., Duca, Aviana, Salinero, Lauren K., Chandragiri, Shreyas, Rios-Diaz, Arturo J., Broach, Robyn B., Caterson, Edward J., Swanson, Jordan W.
• Format: Article
• Language: English
• Subjects: Child, Preschool; Cranial vault remodeling; Craniosynostoses - surgery; Craniosynostosis; Databases, Factual; Female; Humans; Infant; Late presentation; Length of Stay; Male; Patient Readmission - statistics & numerical data; United States
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2024.02.016

Late-repair craniosynostosis (LRC), defined as craniosynostosis surgery beyond 1 year of age, is often associated with increased complexity and potential complications. Our study analyzed data from the 2010–2019 Nationwide Readmissions Database to investigate patient factors related to LRC. Of 10 830 craniosynostosis repair cases, 17% were LRC. These patients were predominantly from lower-income families and had more comorbidities, indicating that socioeconomic status could be a significant contributor. LRC patients were typically treated at teaching hospitals and privately owned investment institutions. Our risk-adjusted analysis revealed that LRC patients were more likely to belong to the lowest-income quartile, receive treatment at privately owned investment hospitals, and use self-payment methods. Despite these challenges, the hospital stay duration did not significantly differ between the two groups. Interestingly, LRC patients faced a higher predicted mean total cost compared with those who had surgery before turning 1. This difference in cost did not translate to a longer length of stay, further emphasizing the complexity of managing LRC. These findings highlight the urgent need for earlier intervention in craniosynostosis cases, particularly in lower-income communities. The medical community must strive to improve early diagnosis and treatment strategies in order to mitigate the socioeconomic and health disparities observed in LRC patients.