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

J Craniomaxillofac Surg. 2024 May;52(5):585-590. doi: 10.1016/j.jcms.2024.02.016. Epub 2024 Feb 12.

Abstract

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.

Keywords: Cranial vault remodeling; Craniosynostosis; Late presentation.

MeSH terms

  • Child, Preschool
  • Craniosynostoses* / surgery
  • Databases, Factual*
  • Female
  • Humans
  • Infant
  • Length of Stay
  • Male
  • Patient Readmission* / statistics & numerical data
  • United States