Aug 11, 2018

National Longitudinal Comparison of Patients Undergoing Surgical Management of Craniosynostosis

The Journal of Craniofacial Surgery
Robin T WuMichael Alperovich

Abstract

Limited cross-institutional studies compare strip craniectomy versus cranial vault remodeling (CVR) for craniosynostosis management. Given competing surgical preferences, the authors conducted a large-scale analysis of socioeconomic differences, costs, and complications between treatment options. Nonsyndromic craniosynostosis patients receiving strip craniectomies or CVR were identified in the Kids' Inpatient Database for years 2000 to 2009. Demographics, socioeconomic background, hospital characteristics, charge, and outcomes were tabulated. Univariate and multivariate analyses were performed for comparison. Two hundred fifty-one strip craniectomies and 1811 CVR patients were captured. Significantly more strip craniectomy patients were White while more CVR patients were Hispanic or Black (P < 0.0001). Strip craniectomy patients more often had private insurance and CVR patients had Medicaid (P < 0.0001). Over time, CVR trended toward treating a higher proportion of Hispanic and Medicaid patients (P = 0.036). Peri-operative charges associated with CVR were $27,962 more than strip craniectomies, and $11,001 after controlling for patient payer, income, bedsize, and length of stay (P < 0.0001). Strip craniectomies were performed mo...Continue Reading

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Citations

Mentioned in this Paper

Craniosynostosis
Univariate Analysis
Hispanics
Puncture Procedure
Calvaria
Strip Craniectomy
West (Direction)
European Continental Ancestry Group
African American
Cross-Sectional Studies

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