Risk Factors for Readmission After Cleft Lip Repair. Issue 7 (October 2019)
- Record Type:
- Journal Article
- Title:
- Risk Factors for Readmission After Cleft Lip Repair. Issue 7 (October 2019)
- Main Title:
- Risk Factors for Readmission After Cleft Lip Repair
- Authors:
- Chouairi, Fouad
Mercier, Michael R.
Mets, Elbert J.
Alperovich, Michael - Abstract:
- Abstract : Background: Cleft lip is the most common craniofacial malformation with an incidence of 1 in 700 live births. Our study sought to evaluate incidences and risk factors readmission following CLP repair using a well-validated national surgical database. Methods: All cleft lip repairs performed between 2012 and 2016 were identified in the American College of Surgeons National Surgical Quality Improvement Program Pediatric Database. Patient demographics, surgical variables, and reasons for readmission were analyzed and identified. A binary logistic regression was performed to identify factors independently associated with readmission following cleft lip repair. Results: The 4550 cleft lip repairs were identified with a thirty-day readmission rate of 3.8% (173 patients). A higher incidence of readmission was identified among patients with developmental delay ( P ⩽0.001), seizure disorder ( P <0.001), structural central nervous system abnormality ( P ⩽0.001), steroid use within 30 days ( P ⩽0.001), a requirement for nutritional support ( P <0.001), and ASA of 3 or higher (17.3% vs 9.9%, P <0.001). Readmitted patients were more likely to have deep incisional surgical site infections ( P <0.001), deep wound dehiscence ( P = 0.002), reoperation ( P <0.001), pneumonia ( P <0.001), and unplanned intubation ( P <0.001). Multivariate regression identified seizure disorder (OR = 3.3; 95% CI = 1.3–8.3; P = 0.012) and steroid use within 30 days (OR = 3.8; 95% CI = 1.1–12.2; PAbstract : Background: Cleft lip is the most common craniofacial malformation with an incidence of 1 in 700 live births. Our study sought to evaluate incidences and risk factors readmission following CLP repair using a well-validated national surgical database. Methods: All cleft lip repairs performed between 2012 and 2016 were identified in the American College of Surgeons National Surgical Quality Improvement Program Pediatric Database. Patient demographics, surgical variables, and reasons for readmission were analyzed and identified. A binary logistic regression was performed to identify factors independently associated with readmission following cleft lip repair. Results: The 4550 cleft lip repairs were identified with a thirty-day readmission rate of 3.8% (173 patients). A higher incidence of readmission was identified among patients with developmental delay ( P ⩽0.001), seizure disorder ( P <0.001), structural central nervous system abnormality ( P ⩽0.001), steroid use within 30 days ( P ⩽0.001), a requirement for nutritional support ( P <0.001), and ASA of 3 or higher (17.3% vs 9.9%, P <0.001). Readmitted patients were more likely to have deep incisional surgical site infections ( P <0.001), deep wound dehiscence ( P = 0.002), reoperation ( P <0.001), pneumonia ( P <0.001), and unplanned intubation ( P <0.001). Multivariate regression identified seizure disorder (OR = 3.3; 95% CI = 1.3–8.3; P = 0.012) and steroid use within 30 days (OR = 3.8; 95% CI = 1.1–12.2; P = 0.030) as independently associated with readmission. The mean time of readmission was 9 days after operation. Conclusion: Patients with seizure disorder and steroid use were significantly more likely to be readmitted. Physicians should be cautious with management of patients with these risk factors. Abstract : Supplemental Digital Content is available in the text … (more)
- Is Part Of:
- Journal of craniofacial surgery. Volume 30:Issue 7(2019)
- Journal:
- Journal of craniofacial surgery
- Issue:
- Volume 30:Issue 7(2019)
- Issue Display:
- Volume 30, Issue 7 (2019)
- Year:
- 2019
- Volume:
- 30
- Issue:
- 7
- Issue Sort Value:
- 2019-0030-0007-0000
- Page Start:
- Page End:
- Publication Date:
- 2019-10
- Subjects:
- Cleft lip repair -- comorbidities -- NSQIP -- readmissions
Facial bones -- Surgery -- Periodicals
Skull -- Surgery -- Periodicals
Face -- Surgery -- Periodicals
Surgery, Plastic -- Periodicals
617.52 - Journal URLs:
- http://gateway.ovid.com/ovidweb.cgi?T=JS&MODE=ovid&PAGE=toc&D=ovft&AN=00001665-000000000-00000 ↗
http://www.jcraniofacialsurgery.com ↗
http://journals.lww.com/jcraniofacialsurgery/pages/default.aspx ↗
http://journals.lww.com ↗ - DOI:
- 10.1097/SCS.0000000000005780 ↗
- Languages:
- English
- ISSNs:
- 1049-2275
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 4965.476000
British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 24424.xml