Article ; Online: Timing of Cleft Palate Repair in Patients With and Without Robin Sequence.
The Journal of craniofacial surgery
2020 Volume 32, Issue 3, Page(s) 931–935
Abstract: ... patients with and without Robin Sequence using a national database of commercial healthcare claims ... Commercial Database based on ICD-9-CM and CPT procedure codes. They were divided into Robin and non-Robin ... cleft palate groups, and further divided by time of initial cleft palate repair: Robin Sequence into 2 ...
Abstract | Background: This cohort study aimed to assess how age at repair affects outcomes in nonsyndromic patients with and without Robin Sequence using a national database of commercial healthcare claims. Methods: Children under 4 years of age undergoing palatoplasty were identified in the IBM MarketScan Commercial Database based on ICD-9-CM and CPT procedure codes. They were divided into Robin and non-Robin cleft palate groups, and further divided by time of initial cleft palate repair: Robin Sequence into 2 groups: age ≤10 months or >10 months; non-Robin cleft palate into 3 groups: age ≤10 months, >10-14 months, or >14 months age. Time to cleft palate revision within each group was assessed using Cox proportional-hazard models. Results: A total of 261 patients with Robin Sequence and 3046 with non-Robin cleft palate were identified. In patients with Robin, later repair was associated with decreased risk of secondary procedures compared with early repair (Hazard Ratio (HR) 0.19, 95%CI 0.09-0.39, P < 0.001). In patients with non-Robin cleft palate, decreased risk of revision compared to early repair was associated both with repair at >10-14 months (adjusted HR 0.40, 95%CI 0.31-0.52, P < 0.001) and > 14 months (adjusted HR 0.71, 95%CI 0.57-0.88, P = 0.002). Adjusting for timing of repair, patients with non-Robin cleft palate were at significantly increased risk of secondary procedure if diagnosed with failure to thrive or anemia in the 30 days prior to palatoplasty. Conclusions: In patients with and without Robin sequence, cleft palate repair at or before 10 months of age was associated with higher risk for secondary procedures. |
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MeSH term(s) | Child ; Child, Preschool ; Cleft Palate/surgery ; Cohort Studies ; Humans ; Infant ; Pierre Robin Syndrome/surgery ; Retrospective Studies ; Treatment Outcome |
Language | English |
Publishing date | 2020-10-23 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 1159501-2 |
ISSN | 1536-3732 ; 1049-2275 |
ISSN (online) | 1536-3732 |
ISSN | 1049-2275 |
DOI | 10.1097/SCS.0000000000007311 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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