National Database Reported Outcomes Following Craniosynostosis Reconstruction

Area of Science:

• Pediatric Surgery
• Health Services Research

Background:

• Craniosynostosis surgery has extensive literature on techniques but limited data on adverse hospital outcomes.
• Understanding complications and health system impacts is crucial for improving patient care.

Purpose of the Study:

• To determine the rates of complications and adverse outcomes following craniosynostosis reconstruction.
• To identify patient-specific risk factors associated with these adverse outcomes.

Main Methods:

• Retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Pediatric database (2012-2016).
• Analysis of 3924 patients undergoing frontoorbital advancement or cranial vault remodeling.
• Logistic regression used to identify risk factors for adverse outcomes, prolonged operative times, transfusions, reoperation, and readmission.

Main Results:

• Transfusion occurred in 66.5% of patients, the most common outcome.
• Reoperation rate was 2.4%, and readmission rate was 3.0%.
• Frontoorbital advancement and cranial vault remodeling were the primary surgical procedures.

Conclusions:

• Nonmodifiable patient factors, including young age, gastrointestinal comorbidities, and high American Society of Anesthesiologist scores, are independent risk factors for readmission.
• Prolonged length of stay and reoperation also independently predict readmission.
• Findings can inform practice standards and enhance ancillary services for safe, cost-effective craniosynostosis care.