330 Socioeconomic Factors, Perioperative Complications, and 30-Day Readmission Rates Associated With Delayed Referral for Cranial Vault Reconstruction for Craniosynostosis

Abstract

INTRODUCTION: Craniosynostosis is the premature fusion of cranial sutures that may lead to neurocognitive, developmental, and aesthetic consequences. As such, a timely intervention with cranial vault reconstruction (CVR) is necessary to optimize patient outcomes. However, there is a paucity of data regarding the impact that delayed surgical correction has on perioperative complications and 30-d readmission rates. The aim of this study was to identify the drivers of delayed CVR and its impact on perioperative complication and 30-d readmission rates. METHOD(S): The medical records of 135 children who underwent primary CVR for craniosynostosis between 2005 and 2017 at a single academic institution were retrospectively reviewed. A delay in operation was defined by primary surgery performed >12 mo of age. Patients who underwent intentional delayed CVR due to medical comorbidities were excluded. Patient demographics, comorbidities, perioperative compli-cation rates, length of hospital stay, and 30-d readmission rates were collected. RESULT(S): A total of 96 patients who underwent primary CVR met the inclusion criteria of this study, with 79 (82.3%) patients undergoing a nondelayed surgery versus 17 (17.7%) patients undergoing a delayed surgery at >12 mo of age. The mean +/- standard deviation (SD) age at surgery was significantly higher among the delayed cohort (no delay: 244.8 +/- 54.5 d vs delay: 759.2 +/- 409.0 d, P CONCLUSION(S): Our study suggests that craniosynostosis patients who are non-White, have a non-English primary language, and have Medicaid insurance are at risk for delayed primary surgery. In turn, delayed primary CVR was associated with higher 30-d readmission rates. Further studies are necessary to better understand how to reduce delays to primary CVR in these populations.