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Impact of Cardiac Risk Factors in the Postsurgical Outcomes of Patients With Cleft Palate: Analysis of the 2012-2014

Christopher J Goodenough1, Kathryn T Anderson2, Kari E Smith3

  • 11 Department of General Surgery, McGovern School of Medicine, The University of Texas Health Science Center at Houston and Children's Memorial Hermann Hospital, Houston, TX, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|September 15, 2018
PubMed

Insights

Cleft palate repair is safe for patients with congenital heart defects, but they face higher postoperative risks. Increased awareness during anesthesia and surgery is crucial for minimizing complications.

Area of Science:

  • Pediatric Surgery
  • Cardiology
  • Public Health

Background:

  • Congenital heart defects are common comorbidities in pediatric patients.
  • Cleft palate repair is a frequent surgical procedure in children.
  • The impact of cardiac comorbidities on cleft palate repair outcomes requires further investigation.

Purpose of the Study:

  • To assess the risk of complications in patients undergoing cleft palate repair who also have congenital cardiac comorbidities.
  • To compare postoperative adverse events between patients with and without cardiac comorbidities undergoing cleft palate repair.

Main Methods:

  • Retrospective review of the 2012-2014 National Surgical Quality Improvement Program (NSQIP) Pediatric database.
  • Stratification of patients based on the presence or absence of congenital cardiac comorbidities.
  • Univariate and stepwise forward logistic regression analysis to identify risk factors.

Main Results:

  • A total of 3240 patients underwent cleft palate repair; 13.0% had cardiac disease.
  • Patients with cardiac disease were smaller, more likely to be premature, and experienced higher rates of adverse events (8.8% vs 4.2%).
  • Specific increased risks included reintubation (1.7% vs 0.4%), reoperation (2.1% vs 0.6%), and longer hospital stays, while surgical site infection and dehiscence rates were similar.

Conclusions:

  • Cleft palate repair in patients with congenital cardiac defects is a safe procedure.
  • Concurrent cardiac defects are associated with an elevated risk of postoperative adverse events.
  • Enhanced awareness and management during anesthesia and surgery are essential to mitigate perianesthesia risks in this population.
Abstract

Keywords:
hard palatepalatoplastysoft palatesurgical complications

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