Cleft Lip and/or Palate Repair in Children With Hypopituitarism: Analysis of the Kids' Inpatient Database.

Autor:	Poupore NS; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.; School of Medicine Greenville, University of South Carolina, Greenville, SC, USA., Chidarala S; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.; College of Medicine, University of Florida, Gainesville, FL, USA., Nguyen SA; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., Teufel RJ 2nd; Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA., Patel KG; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., Pecha PP; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA., Carroll WW; Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
Jazyk:	angličtina
Zdroj:	The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2024 Jan; Vol. 61 (1), pp. 94-102. Date of Electronic Publication: 2022 Jul 29.
DOI:	10.1177/10556656221117435
Abstrakt:	Objective: Children with hypopituitarism (CwHP) can present with orofacial clefting, frequently in the setting of multiple midline anomalies. Hypopituitarism (HP) can complicate medical and surgical care; the perioperative risk in CwHP during the traditionally lower risk cleft lip and/or palate (CL/P) repair is not well described. The objective of this study is to examine the differences in complications and mortality of CL/P repair in CwHP compared to children without hypopituitarism (CwoHP). Design: A retrospective cross-sectional analysis. Setting: The 1997 to 2019 Kids' Inpatient Databases (KID). Patients: Children 3 years old and younger who underwent CL/P repair. Main Outcome Measure(s): Complications and mortality. Results: A total of 34 106 weighted cases were analyzed, with 86 having HP. CwHP had a longer length of stay (3.0 days [IQR 2.0-10.0] vs 1.0 day [IQR 1.0-2.0], P  < .001) and higher rates of complications and mortality (12.8% vs 2.9%, P  < .001) compared to CwoHP. Controlling for demographic factors, CwHP had 6.61 higher odds of complications and mortality than CwoHP (95% CI 3.38-12.94, P  < .001). Conclusions: CwHP can present with a CL/P and other midline defects that can increase the complexity of their care. These data show a significant increase in length of stay, complications, and mortality in CwHP undergoing CL/P repair. Increased multidisciplinary attention and monitoring may be needed for these children peri- and postoperatively, especially if additional comorbidities are present. Further studies on perioperative management in this population are warranted to reduce morbidity and mortality. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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