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Patterns, trends, and factors influencing hospitalizations for craniosynostosis in Western Australia. A
Mohammed Junaid1,2, Linda Slack-Smith3,4, Kingsley Wong4
1School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton Street, Nedlands, 6009, WA, Australia. mohammed.junaid@research.uwa.edu.au.
Insights
Hospitalizations for craniosynostosis (CS) increased, but length of stay decreased. Respiratory infections were a major concern for CS patients, especially those with syndromic synostosis.
Area of Science:
- Pediatric Surgery
- Public Health
- Medical Informatics
Background:
- Craniosynostosis (CS) requires significant hospital services, impacting children's outcomes.
- Understanding hospitalization trends and factors is crucial for optimizing care for CS patients.
Purpose of the Study:
- To analyze population-level trends in hospital service use for craniosynostosis in Western Australia from 1990-2010.
- To identify demographic, perinatal, and clinical factors influencing hospitalizations and length of stay in children with CS.
Main Methods:
- Utilized linked datasets including births, birth defects, hospitalizations, and deaths (1990-2010).
- Employed negative binomial regression to analyze hospitalization trends and incidence rate ratios (IRR) for associated factors.
- Extracted data on admissions, cumulative length of stay (cLoS), ICU, and ED visits for CS and non-CS related events.
Main Results:
- Observed an increasing trend in incident hospitalizations for CS, alongside a marginal decline in cLoS.
- Respiratory infections were significantly higher among CS patients (IRR 1.94-2.34) across all age groups.
- Non-CS hospitalizations were more frequent in females, those with anomalies, from disadvantaged socioeconomic backgrounds, and in remote areas.
Conclusions:
- The reduction in cLoS suggests potential improvements in peri-operative care for CS.
- The high incidence of respiratory infections in syndromic CS warrants further investigation and targeted interventions.
- Optimizing hospital services requires addressing socioeconomic and geographic disparities in care access.
Abstract:
Understanding hospital service use among children with a diagnosis of craniosynostosis (CS) is important to improve services and outcomes. This study aimed to describe population-level trends, patterns, and factors influencing hospitalizations for craniosynostosis in Western Australia. Data on live births (1990-2010; n = 554,624) including craniosynostosis, episodes of death, demographic, and perinatal factors were identified from the midwives, birth defects, hospitalizations, and death datasets. Information on craniosynostosis and non-craniosynostosis-related admissions, cumulative length of hospital stay (cLoS), intensive care unit, and emergency department-related admissions were extracted from the hospitalization dataset and linked to other data sources. These associations were examined using negative binomial regression presented as annual percent change and associations of hospitalizations by age groups, demographic, and perinatal factors were expressed as incidence rate ratio (IRR). We found an increasing trend in incident hospitalizations but a marginal decline in cLoS for craniosynostosis over the observed study period. Perinatal conditions, feeding difficulties, nervous system anomalies, respiratory, and other infections contributed to majority of infant non-CS-related admissions.Respiratory infections accounted for about twice the number of admissions for individuals with CS (IRRs 1.94-2.34) across all observed age groups. Higher incidence of non-CS hospitalizations was observed among females, with associated anomalies, to families with highest socioeconomic disadvantage and living in remote areas of the state. Conclusion: Marginal reduction in the cLoS for CS-related admissions observed over the 21-year period are potentially indicative of improved peri-operative care. However, higher incidence of respiratory infection-related admissions for syndromic synostosis is concerning and requires investigation.
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