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Published on: September 19, 2015
Prevalence, demographics, and complications of cleft palate surgery
Hossein Mahboubi1, Adam Truong1, Nguyen S Pham2
1Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine Medical Center, 101 The City Drive South, Orange, CA 92868, USA.
Insights
Cleft palate repair surgery in California showed stable demographics and low complication rates between 1997 and 2011. This 15-year study of cleft palate correction found no significant changes in incidence or outcomes, indicating a low perioperative risk.
Area of Science:
- Pediatric Surgery
- Craniofacial Surgery
- Health Services Research
Background:
- Published data on cleft lip and palate demographics are sparse and vary internationally.
- Accurate local data on cleft palate repair incidence, demographics, and complications are needed.
- This study investigates cleft palate correction surgery in an inpatient setting over 15 years.
Purpose of the Study:
- To investigate the prevalence and demographics of cleft palate correction surgery.
- To analyze the complication rates associated with cleft palate repair over a 15-year period.
- To compare outcomes between children's hospitals and other facilities.
Main Methods:
- Retrospective review of California Hospital Discharge Data from 1997-2011.
- Analysis of pediatric patients undergoing cleft palate repair or revision.
- Evaluation of age, gender, ethnicity, length of stay, charges, payer, complications, and disposition.
Main Results:
- 10,450 cleft palate correction surgeries were performed, with stable annual volume and population-adjusted rates.
- Complications occurred in 3.8% of surgeries, with no change over time; fistula/abscess/infection was most common.
- Median length of stay remained 1 day, while total charges significantly increased; children's hospitals had shorter stays but higher charges.
Conclusions:
- This statewide study provides an accurate representation of perioperative complication rates for cleft palate repair.
- Prevalence, demographics, and outcomes of cleft palate correction surgery remained consistent from 1997-2011.
- Primary and secondary palatoplasty procedures demonstrate low perioperative risk.
Introduction:
Current published data on the demographics of cleft lip and palate is sparse and differs intranationally in reported incidence, demographics, and complication rates, making accurate local data both valuable and useful. We investigate the prevalence, demographics, and complications of cleft palate correction surgery in the inpatient setting over a 15-year period.
Methods:
A retrospective review of The California Hospital Discharge Data sets of all pediatric patients who underwent cleft palate repair or cleft palate revision from 1997 to 2011. Children's hospitals (CHs) were analyzed as a separate group. For each record, age, gender, ethnicity, length of stay, total charges, principal payer, complications, and disposition were analyzed.
Results:
10,450 correction surgeries were performed during 1997-2011. This was an annual case-volume of 697 and annual population-adjusted rate of 2.0, neither of which changed over time (p=0.9 and 0.06, respectively). Of all surgeries, 21.5% were revisions, 48.3% were performed in CHs, 56.2% were performed on males, and 65.5% were performed on Caucasians. The median length of stay was 1 day, which did not change over time (p=1.0). The median total charges increased from $9.074 to $35,643 over the studied period (p<0.001). Admission to CHs was associated with shorter stay (1-3 days vs. 1-4 days) and higher total charges ($15,560 vs. $13,242; both p<0.001). Complications occurred in 393 (3.8%) of the surgeries. This percentage did not change over time (p=0.2). The most common complication was fistula/abscess/infection, which occurred in 159 cases (1.5%). Respiratory complications requiring ventilation occurred 66 cases (0.6%). Complications were more common in CHs (4.8% vs. 2.8%; p<0.001). Mortality rate was <0.1%.
Conclusions:
Our study constitutes the entire surgical cohort within a state, allowing for an accurate representation of the true perioperative complication rate of these procedures. The prevalence, demographics, and outcomes of the cleft palate correction surgery have remained unchanged during 1997-2011. Collectively, our data suggest that primary and secondary palatoplasty present low perioperative risk.
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