A Retrospective Review of Craniosynostosis Reconstruction at a Community Children's Hospital Compared With Academic Centers.

BACKGROUND

Craniosynostosis repair is traditionally performed at high-volume academic centers with multidisciplinary teams. Access barriers in rural or suburban regions raise the question of whether comparable outcomes can be achieved and if this surgery can be performed safely in community settings.

OBJECTIVE

To evaluate the safety and perioperative outcomes of cranial vault reconstruction for craniosynostosis performed at a community-based children's hospital and compare these outcomes to those reported at academic institutions.

MATERIALS AND

METHODS

A retrospective chart review of 45 pediatric patients undergoing craniosynostosis repair (either open cranial vault reconstruction or endoscopic craniectomy) at Children's Hospital Colorado in Colorado Springs was conducted. Perioperative variables, including operative time, transfusion rates, complications, and revision rates, were analyzed. A meta-analysis of academic studies reporting similar outcomes was then performed for descriptive comparison between our community and the existing academic data.

RESULTS

Open repair and endoscopic cohorts at our community hospital demonstrated no intraoperative complications and low revision rates. Estimated blood loss (EBL), transfusion volumes, length of stay, and operative times were comparable to data published by academic centers. Postoperative complications were rare, and all patients recovered well. Despite relatively more limited resources and an absence of surgical residents and fellows, our community center's outcomes were comparable to academic centers.

CONCLUSION

This study is one of the first to report variables of craniosynostosis surgery from a community-based center and to compare this data to the existing literature reported by academic centers, supporting the feasibility and safety of these surgeries outside academic institutions. Our data suggest that community hospitals can deliver comparable high-quality craniofacial surgical care for pediatric craniosynostosis repair.