Cleft and Craniofacial Multidisciplinary Team Clinic: A Look at Attrition Rates for Patients With Complete Cleft Lip and Palate and Nonsyndromic Single-Suture Craniosynostosis

Objective: To evaluate attrition rates prior to expected completion of team care for children with complete cleft lip and palate (cleft) or nonsyndromic single-suture craniosynostosis (synostosis). Design: A single-institution retrospective review of attendance data from 2002 to 2016. Setting: Singl...

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Bibliographic Details
Published in:The Cleft palate-craniofacial journal 2019-11, Vol.56 (10), p.1287-1294
Main Authors: Cooper, Danielle C., Peterson, Erin C., Grellner, Cheryl G., Naidoo, Sybill D., Skolnick, Gary B., Pfeifauf, Kristin D., Smyth, Matthew D., Snyder-Warwick, Alison K., Patel, Kamlesh B.
Format: Article
Language:English
Subjects:
Age
Attrition
Birth defects
Children & youth
Clinics
Dentistry
Patients
Regression analysis
Studies
Survival analysis
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Summary:Objective: To evaluate attrition rates prior to expected completion of team care for children with complete cleft lip and palate (cleft) or nonsyndromic single-suture craniosynostosis (synostosis). Design: A single-institution retrospective review of attendance data from 2002 to 2016. Setting: Single cleft and craniofacial center in the United States. Patients/Participants: A sample of 983 patients with either cleft or synostosis. Patients who were more than 2 to 3 years from their last visit were considered lost to follow-up. Patients with cleft older than 16 years or synostosis over 11 years were considered graduated from team care. Results: Survival analysis shows that in our patients with cleft, 25% leave before age 8 and over 60% are lost from team by age 16. In patients with synostosis, 25% leave before age 6 and 45% are lost by age 11. Cox regression showed underrepresented minorities being 1.7 times more likely to become lost in the cleft group (hazard ratio: 1.66, 95% confidence interval [CI]: 1.01-2.74). Conclusions: Overall, attrition rates were high at our institution. Many patients are lost to follow-up prior to receiving key medical interventions. Improved family education and personalized care are needed to help ensure continuity of care.
ISSN:1055-6656
1545-1569
DOI:10.1177/1055665619856245