A Nationwide Analysis of the Impact of Craniofacial Syndromes on Mandibular Distraction Osteogenesis Outcomes
Objective
To investigate how craniofacial syndromes influence surgical outcomes of mandibular distraction osteogenesis (MDO), in order to optimize perioperative care.
Design
Retrospective cohort.
Setting
Single-center.
Patients/Participants
The American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-Pediatric) database was queried for relevant Current Procedural Terminology (CPT) codes from 2012 to 2022. Patients with craniofacial syndromes were identified using ICD-9 and ICD-10 codes.
Intervention
Mandibular distraction osteogenesis.
Main Outcome Measures
30-day perioperative adverse events including reoperation, readmission, and complications such as infection, dehiscence, pneumonia, sepsis, stroke, intracranial hemorrhage, nerve injury, and death.
Results
A total of 209 patients were identified, with 77 (36.8%) having a craniofacial syndrome. The average age at MDO was significantly younger for patients with craniofacial syndromes (99 days) versus the nonsyndromic group (389 days). Patients with craniofacial syndromes had a higher likelihood of undergoing reoperation within 30 days postoperatively ( P = .003) and experienced a 1.5 times longer average length of stay (LOS) ( P = .039). Additionally, these patients were less likely to achieve same-day discharge ( P = .033). Although the overall complication rate was slightly higher in patients with craniofacial syndromes, these differences were not statistically significant.
Conclusions
This nationwide analysis indicates that while overall complication rates for MDO are similar, those with craniofacial syndromes face greater challenges, including higher reoperation rates, longer LOS, and lower same-day discharge rates, compared to patients without craniofacial syndromes. These results underscore the need for tailored postoperative care strategies to improve outcomes for this unique patient population.
