Nationwide Children's Hospital, Columbus, OH, USA.
Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.
Cleft Palate Craniofac J. 2023 Jun;60(6):663-670. doi: 10.1177/10556656221078154. Epub 2022 Feb 9.
To determine how race and ethnicity affect palatoplasty 30-day outcomes.
Retrospective review.
PATIENTS/SETTING: The 2012 to 2019 National Surgical Quality Improvement Program (NSQIP) Pediatric database was used to identify patients ≤ 2 years who underwent primary palatoplasty. We compared demographics, comorbidities, and 30-day outcomes among different racial and ethnic groups. Logistic regression was used to determine independent risk factors for adverse events.
Increased risk for adverse events and postoperative surgical outcomes, including complications, readmission, and prolonged length of stay.
A total of 8537 patients were identified in the database. African-American patients had the highest proportion of premature infants and infants with a BMI < 15% at the time of repair. Asian patients underwent palatoplasty at a later age compared to other races (12.7 months vs 11.7-12.1 months). Postoperatively, the odds of a complication were significantly higher in Asian patients (aOR = 1.73, 95% CI: 1.17-2.57) and other/unknown patients (aOR = 1.40, 95% CI: 1.05-1.86), but not among African American (aOR = 1.02, 95% CI: 0.70-1.47) or Hispanic (aOR = 0.93, 95% CI: 0.69-1.26) patients. Other/unknown patients were more likely to require postoperative ventilation (aOR = 2.34, 95% CI: 1.38-3.95). The odds of readmission were highest in Asian and other/unknown patients. African American, Hispanic, and other/unknown patients were more likely than Caucasian patients to be hospitalized > 2 days postoperatively.
This study highlights ethnic differences in presentation and 30-day outcomes following palatoplasty. Further evaluation of disparities in cleft care should be performed to improve healthcare access and surgical outcomes.
确定种族和民族如何影响腭裂修补术 30 天的结果。
回顾性研究。
患者/设置：使用 2012 年至 2019 年国家外科质量改进计划（NSQIP）儿科数据库，确定≤2 岁接受初次腭裂修补术的患者。我们比较了不同种族和民族的人群特征、合并症和 30 天的结果。使用逻辑回归确定不良事件的独立危险因素。
不良事件和术后手术结果的风险增加，包括并发症、再入院和延长住院时间。
在数据库中确定了 8537 例患者。非裔美国患者中早产儿和修复时 BMI<15%的婴儿比例最高。与其他种族相比，亚洲患者接受腭裂修补术的年龄较大（12.7 个月比 11.7-12.1 个月）。术后，亚洲患者（aOR=1.73，95%CI：1.17-2.57）和其他/未知患者（aOR=1.40，95%CI：1.05-1.86）发生并发症的可能性显著更高，但非裔美国患者（aOR=1.02，95%CI：0.70-1.47）或西班牙裔患者（aOR=0.93，95%CI：0.69-1.26）并非如此。其他/未知患者更有可能需要术后通气（aOR=2.34，95%CI：1.38-3.95）。亚洲患者和其他/未知患者再入院的可能性最高。非裔美国、西班牙裔和其他/未知患者术后住院时间超过 2 天的可能性高于白种人患者。
本研究强调了腭裂修补术后表现和 30 天结果的种族差异。应进一步评估腭裂护理中的差异，以改善医疗保健的可及性和手术结果。
