Annals of plastic surgery · 2026
Associations of Hospital-Level and Regional Factors With Receipt of Endoscopic Repair for Nonsyndromic Craniosynostosis.
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Kim Dylan K, Zhou Maggie H, Ascherman Jeffrey A
Аннотация
BACKGROUND: Endoscopic strip craniectomy represents an alternative to open cranial vault remodeling for repair of craniosynostosis. In addition to individual sociodemographic factors, hospital-level variables may affect the reception of such endoscopic procedures. This study incorporates a large national database to identify hospital-level and regional determinants of endoscopic repair for nonsyndromic craniosynostosis.
METHODS: Open cranial vault remodeling and endoscopic strip craniectomy surgeries were identified in the 2016-2022 National Inpatient Sample. Admissions were characterized by hospital-level factors, such as hospital census division, bed size, ownership, and annual overall plastic surgery institutional volume. A multivariable logistic regression model was used to evaluate independent predictors of endoscopic repair ( P < 0.05).
RESULTS: The final cohort comprised 12,785 nonsyndromic craniosynostosis repairs, 600 (4.7%) of which were endoscopic strip craniectomy procedures. Public hospital ownership was associated with lower odds of endoscopic repair compared to private nonprofit ownership (odds ratio [OR]: 0.30, 95% confidence interval [CI]: 0.21-0.43). Higher institutional plastic surgery volume also conferred higher odds (OR: 1.34, 95% CI: 1.25-1.43 per 100 cases). When compared to the Pacific region, all census divisions except the Mid-Atlantic (OR: 1.04, 95% CI: 0.72-1.51) and Mountain (OR: 0.84, 95% CI: 0.54-1.32) regions were associated with higher odds of endoscopic repair ( P < 0.05).
CONCLUSIONS: Multiple hospital-level factors, including hospital census division, ownership, and case volume, are associated with receipt of endoscopic strip craniectomy. This may reflect the impact of both state-specific insurance coverage and institutional experience on reception of endoscopic repair for nonsyndromic craniosynostosis.
METHODS: Open cranial vault remodeling and endoscopic strip craniectomy surgeries were identified in the 2016-2022 National Inpatient Sample. Admissions were characterized by hospital-level factors, such as hospital census division, bed size, ownership, and annual overall plastic surgery institutional volume. A multivariable logistic regression model was used to evaluate independent predictors of endoscopic repair ( P < 0.05).
RESULTS: The final cohort comprised 12,785 nonsyndromic craniosynostosis repairs, 600 (4.7%) of which were endoscopic strip craniectomy procedures. Public hospital ownership was associated with lower odds of endoscopic repair compared to private nonprofit ownership (odds ratio [OR]: 0.30, 95% confidence interval [CI]: 0.21-0.43). Higher institutional plastic surgery volume also conferred higher odds (OR: 1.34, 95% CI: 1.25-1.43 per 100 cases). When compared to the Pacific region, all census divisions except the Mid-Atlantic (OR: 1.04, 95% CI: 0.72-1.51) and Mountain (OR: 0.84, 95% CI: 0.54-1.32) regions were associated with higher odds of endoscopic repair ( P < 0.05).
CONCLUSIONS: Multiple hospital-level factors, including hospital census division, ownership, and case volume, are associated with receipt of endoscopic strip craniectomy. This may reflect the impact of both state-specific insurance coverage and institutional experience on reception of endoscopic repair for nonsyndromic craniosynostosis.