Abstract
Objective
Optimal timing for primary cleft lip (CL) repair remains controversial due to a paucity of literature reporting outcomes. This study sought to identify trends in timing of CL repair over a 10-year period.
Design and Setting
Cross-sectional analysis of the National Surgical Quality Improvement Program-Pediatrics (NSQIP-P) between 2013 and 2022.
Patients, Participants, Interventions
CL patients undergoing primary CL repair were divided into 4 cohorts based on age (months) at repair: 0 to 3, 3 to 6, 6 to 9, and 9 to 12.
Main Outcome Measure
Univariable statistics, multivariable regressions, and trend analyses were conducted to identify predictors for operation at latter ages and to evaluate trends over time.
Results
11,585 CL patients were identified with the majority undergoing repair between 3 and 6 months of age (63%). White and Asian patients predominately underwent repair between 0 and 3 months (68% and 5%, respectively), while African American and Hispanic patients underwent repair between 9 and 12 months (12% and 22%, respectively, P < .001). On regression analysis, patients with cardiac risk factors (CRF), asthma, bronchopulmonary dysplasia, developmental delay, CNS abnormalities, and nutritional supplementation (P < .001) were more likely to be repaired at later time intervals. Over the past decade, Hispanic and Asian patients undergoing CL repair increased between 0 and 3 (β = 0.06) and 3 and 6 (β = 0.05) months of age, respectively. Patients with CRF and airway abnormalities also significantly increased between 0 and 3 months.
Conclusion
The present study identified an increase in non-White patients and patients with severe comorbidities undergoing early CL repair over a 10-year period. Healthcare professionals should note these trends when treating their own patient populations.
Keywords
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Supplementary Material
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