Skip to main content
2024 AANS Annual Scientific Meeting Main banner
Back

Neurosurgeon Forum

Pediatrics

Associated Risk Factors for Extended Length of Stay following Cranial Vault Remodeling for Craniosynostosis: Analysis of the 2012 to 2021 NSQIP-Pediatric Database

Friday, May 3, 2024
1:10 PM – 1:14 PM CT
Location:  S401ab
Disclosure(s):
Aladine A. Elsamadicy, MD: No financial relationships to disclose
Introduction: The aim of this study was to identify the factors associated with extended length of stay (LOS) for pediatric patients with craniosynostosis undergoing cranial vault remodeling (CVR).

Methods: A retrospective cohort study was performed using the 2012-2021 ACS NSQIP – Pediatric database. Pediatric patients < 2 years with craniosynostosis who underwent CVR were identified using CPT and ICD-9/10 codes. Patients were dichotomized according to whether they encountered an extended postoperative hospital LOS, which was defined as LOS greater than the 75th percentile for the entire cohort (4 days). Patient demographics, comorbidities, intraoperative variables, postoperative adverse events (AEs), and healthcare resource utilization were assessed. Multivariate logistic regression analysis was utilized to identify predictors of prolonged length of stay.

Results: In our cohort of 9,784 patients, 1,312 (13.4%) experienced an extended LOS. The extended LOS-cohort was significantly older than the normal LOS cohort (Normal LOS: 225.1±141.8 days vs. Extended LOS: 314.4±151.7 days, p< 0.001) and had a smaller proportion of non-Hispanic white patients (Normal LOS: 70.0% vs. Extended LOS: 61.2%, p< 0.001). Overall, comorbidities and adverse events were significantly higher in the extended-LOS cohort than the normal-LOS cohort. On multivariate logistic regression, independent associations of extended LOS included age, race and ethnicity, weight, ASA classification, impaired cognitive status, structural pulmonary abnormalities, asthma, and neuromuscular disorders.

Conclusion : Our study demonstrates that age, race, comorbidities, and perioperative complications contribute to extended LOS after cranial vault remodeling for craniosynostosis. Further investigations to further elucidate the risk factors of extended LOS is warranted to optimize patient outcomes.