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Published on: October 20, 2023
Cleft Palate Revision Surgery: A Report on Sociodemographic and Racial Influences
Anna G Boydstun1,2, Shelley R Edwards1,2, Ashlie A Elver1,2
1School of Medicine, University of Mississippi Medical Center.
Objective:
To evaluate the impact of sociodemographic factors on the likelihood of subsequent cleft surgeries after primary palatoplasty using a large national data set.
Design:
A retrospective cohort study was designed using Epic Cosmos, a HIPAA-compliant database of >200 million patients from >1000 hospitals.
Patients:
Patients with cleft palate who underwent primary palatoplasty from 2013 to 2023 were queried and divided into sociodemographic cohorts based on: (1) Social Vulnerability Index (SVI), 2) race, (3) urbanicity.
Main Outcome Measures:
The rate of major revision surgeries and surgical correction of velopharyngeal insufficiency (VPI).
Results:
Socially vulnerable and Black patients displayed the lowest rates of major revisions and speech surgeries. Vulnerable patients of minority and language status were also susceptible to low revision rates (P<.001). Asian and Pacific Islander race exhibited the highest rate of major revisions and speech surgery.
Conclusions:
Socially vulnerable minorities and Black patients undergo fewer corrective procedures than their counterparts. This may indicate differences in access and under-recognition of surgical needs in such patients.
