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Sociodemographic Factors Associated with Late Presentation in Nonsyndromic Sagittal Synostosis
Trey D Watmore1, Alma Jukic2, Santana S Solomon2
1Phoenix Children's Center for Cleft and Craniofacial Care, Division of Plastic, Reconstructive, and Maxillofacial Surgery, Phoenix Children's, Phoenix, AZ, USA.
Insights
Sociodemographic factors influence craniosynostosis treatment timing. Patients with later presentation for nonsyndromic sagittal synostosis had lower income, were more likely Hispanic, and had lower parental education.
Area of Science:
- Pediatric Surgery
- Craniofacial Surgery
- Health Services Research
Background:
- Craniosynostosis, a premature fusion of skull sutures, requires timely intervention to optimize outcomes.
- Sociodemographic factors may influence healthcare access and timely presentation for pediatric surgical conditions.
- Understanding these disparities is crucial for improving perioperative care in craniosynostosis.
Purpose of the Study:
- To investigate the association between sociodemographic variables and the timing of surgical presentation in patients with nonsyndromic sagittal synostosis.
- To identify patient populations who may experience delays in receiving craniosynostosis treatment.
- To inform strategies for equitable access to timely surgical care.
Main Methods:
- Retrospective cohort study of patients with nonsyndromic sagittal synostosis undergoing surgery between 2007 and 2024.
- Comparison of demographic data, including ethnicity, insurance status, parental education, and median household income, between early and late repair groups.
- Analysis of Social Vulnerability Index (SVI) and Area Deprivation Index (ADI) scores.
Main Results:
- Patients undergoing late repair were significantly older at consultation (1.01 years vs. 0.18 years).
- Late repair patients were more likely to be Hispanic, on public insurance, have lower parental education, and lower median household income.
- No significant difference was observed in ADI or SVI scores between early and late repair groups.
Conclusions:
- Sociodemographic factors, including ethnicity, insurance status, parental education, and income, are associated with delayed presentation for nonsyndromic sagittal synostosis.
- These findings highlight potential healthcare access barriers impacting timely treatment for certain patient populations.
- Targeted interventions may be necessary to mitigate disparities and ensure equitable access to early craniosynostosis repair.
Abstract:
Objective: Our objective is to examine which sociodemographic factors may influence the time of presentation of patients with craniosynostosis, which can impact perioperative outcomes. Design: Retrospective cohort study. Setting: Tertiary pediatric hospital. Patients, Participants: All patients with nonsyndromic sagittal synostosis who underwent surgery at a tertiary pediatric hospital from January 1, 2007 to January 2, 2024 were eligible for inclusion. Interventions: Comparing demographic variables between those undergoing early and late craniosynostosis repair. Main Outcome Measure(s): Demographic variables, social vulnerability index (SVI) and area deprivation index (ADI), median household income, education rate, and employment rates. Results: 77.5% (n = 234) of patients underwent minimally invasive repair. 22.5% (n = 68) underwent open cranial vault remodeling. Age at consultation differed significantly between those undergoing early repair compared to late repair (0.18 years v. 1.01 years, P < .0001). Patients undergoing late repair were more likely to be Hispanic (42.6% v. 24.4%, P = .0378), on public insurance (66.2% v. 45.3%, P = .0079), have lower parental education rates (24.78% vs. 31.64%, P = .0019), and lower median household income ($65 657 vs. $75 281, P = .0226). Interestingly, ADI scores and SVI scores did not significantly differ between groups. Conclusions: Patients who presented later for treatment of nonsyndromic sagittal synostosis had lower median household income, were more likely to be Hispanic, had lower parental education rates, and were more likely to be on public insurance compared to those who received early treatment.
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