Harb Jennifer L, Crawford Kayva L, Simmonds Jonathan C, Roberts Cullen, Scott Andrew R
Otolaryngology - Head and Neck Surgery, Tufts Medical Center, Boston, USA.
Otolaryngology - Head and Neck Surgery, University of California San Diego School of Medicine, San Diego, USA.
Cureus. 2021 Feb 18;13(2):e13414. doi: 10.7759/cureus.13414.
Objective To determine if differences exist in the timing of cleft palate repair with respect to sex, race, income, and geographical location within the United States. Design Retrospective cross-sectional study using the Kids' Inpatient Database (KID) from 1997 to 2009. Setting Inpatient. Patients Children with cleft palate with or without cleft lip undergoing inpatient cleft palate repair. Main outcome measures Age at the time of palatoplasty (in months) by sex, race, income quartile, and geographic location. Results A total of 7,218 children with cleft palate underwent repair at a mean age of 12.1 months (95% CI 12.0-12.3). Females underwent palatoplasty at an older age (13.6 months) than males (13.2 months), a difference of 0.47 months (SE: 0.19, p=0.015). White children underwent surgery at an earlier age (12.1 months) than Black (12.9 months) (difference: 0.73 months, SE: 0.37, p=0.045), Hispanic (12.7 months) (difference: 0.57 months, SE 0.25, p=0.025), and Asian children (15.7 months) (difference: 3.60 months, SE 0.49, p<0.0001). Asian children were also found to undergo repair later than Hispanic (difference 3.03 months, SE 0.51, p<0.0001) and Black (difference: 2.87 months, SE 0.59, p<0.0001) children. Patients born into the highest income brackets were repaired 0.75 months earlier than those in the lowest bracket (SE: 0.26, p=0.005). Patients in the Midwest underwent palatoplasty later (14.3 months) than in the Northeast (12.9 months) (difference: 1.36 months, SE: 0.31, p<0.0001), South (13.2 months) (difference: 1.05 months, SE: 0.36, p=0.004), and West (13.2 months) (difference: 1.09 months, SE: 0.32, p=0.0007). Conclusions After controlling for confounding factors, our results suggest that in recent history, Black, Hispanic, and Asian children with cleft palate were repaired later than their White counterparts. In addition, children of affluent families were repaired earliest, and economically disadvantaged children were repaired later than their peers.
目的 确定在美国，腭裂修复手术的时间在性别、种族、收入和地理位置方面是否存在差异。设计 采用1997年至2009年儿童住院数据库（KID）进行回顾性横断面研究。地点 住院部。患者 患有腭裂（无论是否伴有唇裂）且接受住院腭裂修复手术的儿童。主要观察指标 按性别、种族、收入四分位数和地理位置划分的腭裂修复时的年龄（以月为单位）。结果 共有7218名腭裂患儿接受了修复手术，平均年龄为12.1个月（95%可信区间12.0 - 12.3）。女性接受腭裂修复手术的年龄（13.6个月）比男性（13.2个月）大，相差0.47个月（标准误：0.19，p = 0.015）。白人儿童手术年龄（12.1个月）比黑人（12.9个月）早（相差：0.73个月，标准误：0.37，p = 0.045），比西班牙裔（12.7个月）早（相差：0.57个月，标准误0.25，p = 0.025），比亚洲儿童（15.7个月）早（相差：3.60个月，标准误0.49，p < 0.0001）。还发现亚洲儿童比西班牙裔儿童（相差3.03个月，标准误0.51，p < 0.0001）和黑人儿童（相差：2.87个月，标准误0.59，p < 0.0001）接受修复手术的时间晚。出生在最高收入阶层的患者比最低收入阶层的患者修复时间早0.75个月（标准误：0.26，p = 0.005）。中西部地区的患者接受腭裂修复手术的时间（14.3个月）比东北部地区（12.9个月）晚（相差：1.36个月，标准误：0.31，p < 0.00
