Multidisciplinary Collaborative Efforts in Craniosynostosis Surgery-A Rural Appalachian Institutional Experience in...

Area of Science:

• Pediatric Surgery
• Neurosurgery
• Health Services Research

Background:

• Craniosynostosis surgery requires standardized protocols for optimal outcomes, particularly in rural healthcare settings.
• Variations in care can impact patient outcomes, including transfusion rates and length of stay.

Purpose of the Study:

• To evaluate surgical outcomes for craniosynostosis from 2012-2021, focusing on 2020-2021.
• To assess the impact of specific interventions like erythropoietin and antifibrinolytic use on perioperative blood transfusions and hospital stays.
• To analyze outcomes across different hospitals, with a specific emphasis on a Rural Appalachian Institution (RAI).

Main Methods:

• Retrospective analysis of surgical outcomes from 2012 to 2021.
• Assessment of intraoperative blood product use, blood donor exposures, antifibrinolytic use, and length of ICU and hospital stays.
• Statistical analysis using ANOVA and chi-square tests (p < 0.05 significance).

Main Results:

• Preoperative erythropoietin administration at RAI was associated with reduced perioperative blood transfusions.
• Increased antifibrinolytic use at RAI correlated with efforts to minimize transfusions.
• Variations in ICU and hospital stays were observed, but RAI's protocols addressed regional challenges.

Conclusions:

• Standardized protocols, including the use of erythropoietin and antifibrinolytics, can optimize craniosynostosis surgery outcomes in rural settings.
• RAI's approach demonstrates effective management of resource limitations.
• Further research is recommended on erythropoietin, dexmedetomidine, and tranexamic acid for blood conservation and perioperative management.