Prevalence and impact of complications on hospitalization outcomes following surgical repair for craniosynostosis

Abstract

Purpose: The objective of the present study was to examine the association between different types of complications and hospitalization outcomes in patients having surgical repair for craniosynostosis.

Materials and methods: The Nationwide Inpatient Sample for 2004 through 2010 was used. All patients up to 3 years old who underwent surgical repair for craniosynostosis were selected for analysis. The primary independent variable was occurrence of different types of complications. The outcomes of interest included hospital charges and length of hospital stay.

Results: During the study period, 17,788 hospitalizations concerned a surgical repair for craniosynostosis. Most procedures were performed in those younger than 1 year (77.7% of hospitalizations). Female patients comprised 65.2% of hospitalizations. After hospitalization, 98% were discharged routinely. Fifteen patients died in the hospital. Complications occurred in 10.1% of hospitalizations. The 5 frequently reported complications were hemorrhage (4.1%); iatrogenically induced complications, including accidental punctures, lacerations, or pneumothorax (3.1%); cardiac complications (0.7%); bacterial infections (0.7%); and respiratory complications (0.7%). Patients who developed nonhealing wounds, hemorrhages, infections, iatrogenically induced complications, respiratory complications, nervous system complications, and cardiac complication were associated with significantly higher hospitalization charges, whereas those who developed septicemia, bacterial infections, mycoses, hemorrhage, other infections, iatrogenically induced complications, vascular complications, digestive system complications, nervous system complications, and postoperative pneumonia were associated with significantly longer duration of hospital stay (P<.05).

Conclusions: Catastrophic adverse outcomes, such as in-hospital mortality, were reported in 0.08% of patients who underwent surgical repair of craniosynostosis. When complications occurred, they were associated with significantly higher hospital charges and longer length of hospital stay.