Tags

Type your tag names separated by a space and hit enter

Statewide multicenter analysis of the incidence of secondary surgeries after isolated cleft palate repair.
Ann Plast Surg. 2014 May; 72 Suppl 1:S71-5.AP

Abstract

INTRODUCTION

Previous smaller studies have reported a wide range, 15% to 45%, of secondary palate surgery. The goal of this study was to report the true incidence of secondary surgery derived from a large statewide database as well as study the timing and risk factors for secondary surgery.

METHODS

Retrospective longitudinal analysis was performed of the 1995 to 2010 California Office of Statewide Health Planning and Development patient discharge database, which allows patients to be followed up over time. Patients were included in the study if they had an isolated palate diagnosis in addition to a primary repair code and excluded if they ever carried a cleft lip diagnosis or repair code.

RESULTS

A total of 2616 isolated cleft palate patients were identified with a median follow-up of 8.0 years. At 16 years, the overall rate of second surgery was 13.6% with complete cleft palate patients having a higher rate of second surgery (15.92%) than the incomplete cleft palate patients (12.36%). The risk of second surgery over time showed a bimodal distribution; the first peak was seen in the first postoperative year and the second peak was seen 3 to 5 years postoperative. On multivariate regression, the only independent risk factor of a secondary surgery was uninsured status (HR, 4.55 [1.64-12.64]), whereas incomplete cleft palate (HR, 0.68 [0.46-0.98]) and Hispanic ethnicity (HR, 0.68 [0.50-0.94]) were found to be protective for secondary surgery with the rest of the covariates not showing significant association.

CONCLUSIONS

The incidence rate of secondary surgery (13.6%) at 16 years was less than reported in the literature. Patients who had a complete cleft palate repaired showed a higher incidence rate compared with those who had an incomplete cleft repaired, likely correlating with the complexity and invasiveness of the primary surgery. The first risk peak at which secondary surgeries were performed reflects the short-term complications that needed to be addressed within the first postoperative year. The second peak reflects the longer-term complications diagnosed at the age at which children reach speech milestones.

Authors+Show Affiliations

From the *Department of Surgery, and †Division of Plastic Surgery, Department of Surgery, University of California, San Diego, San Diego, CA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

24740028

Citation

Parina, Ralitza Petrova, et al. "Statewide Multicenter Analysis of the Incidence of Secondary Surgeries After Isolated Cleft Palate Repair." Annals of Plastic Surgery, vol. 72 Suppl 1, 2014, pp. S71-5.
Parina RP, Chang DC, Saad AN, et al. Statewide multicenter analysis of the incidence of secondary surgeries after isolated cleft palate repair. Ann Plast Surg. 2014;72 Suppl 1:S71-5.
Parina, R. P., Chang, D. C., Saad, A. N., Tokin, C. A., & Gosman, A. A. (2014). Statewide multicenter analysis of the incidence of secondary surgeries after isolated cleft palate repair. Annals of Plastic Surgery, 72 Suppl 1, S71-5. https://doi.org/10.1097/SAP.0000000000000172
Parina RP, et al. Statewide Multicenter Analysis of the Incidence of Secondary Surgeries After Isolated Cleft Palate Repair. Ann Plast Surg. 2014;72 Suppl 1:S71-5. PubMed PMID: 24740028.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statewide multicenter analysis of the incidence of secondary surgeries after isolated cleft palate repair. AU - Parina,Ralitza Petrova, AU - Chang,David C, AU - Saad,Ahmad N, AU - Tokin,Christopher A, AU - Gosman,Amanda A, PY - 2014/4/18/entrez PY - 2014/4/18/pubmed PY - 2014/12/17/medline SP - S71 EP - 5 JF - Annals of plastic surgery JO - Ann Plast Surg VL - 72 Suppl 1 N2 - INTRODUCTION: Previous smaller studies have reported a wide range, 15% to 45%, of secondary palate surgery. The goal of this study was to report the true incidence of secondary surgery derived from a large statewide database as well as study the timing and risk factors for secondary surgery. METHODS: Retrospective longitudinal analysis was performed of the 1995 to 2010 California Office of Statewide Health Planning and Development patient discharge database, which allows patients to be followed up over time. Patients were included in the study if they had an isolated palate diagnosis in addition to a primary repair code and excluded if they ever carried a cleft lip diagnosis or repair code. RESULTS: A total of 2616 isolated cleft palate patients were identified with a median follow-up of 8.0 years. At 16 years, the overall rate of second surgery was 13.6% with complete cleft palate patients having a higher rate of second surgery (15.92%) than the incomplete cleft palate patients (12.36%). The risk of second surgery over time showed a bimodal distribution; the first peak was seen in the first postoperative year and the second peak was seen 3 to 5 years postoperative. On multivariate regression, the only independent risk factor of a secondary surgery was uninsured status (HR, 4.55 [1.64-12.64]), whereas incomplete cleft palate (HR, 0.68 [0.46-0.98]) and Hispanic ethnicity (HR, 0.68 [0.50-0.94]) were found to be protective for secondary surgery with the rest of the covariates not showing significant association. CONCLUSIONS: The incidence rate of secondary surgery (13.6%) at 16 years was less than reported in the literature. Patients who had a complete cleft palate repaired showed a higher incidence rate compared with those who had an incomplete cleft repaired, likely correlating with the complexity and invasiveness of the primary surgery. The first risk peak at which secondary surgeries were performed reflects the short-term complications that needed to be addressed within the first postoperative year. The second peak reflects the longer-term complications diagnosed at the age at which children reach speech milestones. SN - 1536-3708 UR - https://www.unboundmedicine.com/medline/citation/24740028/Statewide_multicenter_analysis_of_the_incidence_of_secondary_surgeries_after_isolated_cleft_palate_repair_ L2 - http://dx.doi.org/10.1097/SAP.0000000000000172 DB - PRIME DP - Unbound Medicine ER -