AAPS Main Site  |  Past & Future Meetings
American Association of Plastic Surgeons

Back to 2022 Abstracts


Surgical Timing And Neurocognitive Development Among Patients With Craniosynostosis: Analysis Of Confounding Variables And Selection Bias
Jeremy V. Lynn, BS, Lauren K. Buchman, N/A, Christopher J. Breuler, MD, Steven R. Buchman, MD.
University of Michigan, Ann Arbor, MI, USA.

Purpose: In 1988, Renier et al postulated that delayed cranial vault remodeling causes slowed neurocognitive development among patients with craniosynostosis. The purpose of this study is to identify factors potentially confounding this cause-and-effect relationship. We hypothesize that children with socioeconomic disadvantages or comorbid diagnoses are more likely to undergo delayed cranial vault remodeling and may represent a selection bias toward slowed neurocognitive development.
Methods: A retrospective review study was designed. All patients with non-syndromic single-suture craniosynostosis who underwent cranial vault remodeling between 2009 and 2020 at the University of Michigan were included (n=227). Demographic, socioeconomic, and clinical variables were documented. The sample was dichotomized to compare patients who underwent cranial vault remodeling before (Early) and after (Late) 12 months of age. Chi-square analysis was performed at p<0.05 significance.
Results: The Early and Late groups contained 157 patients and 70 patients, respectively. Compared to the Early group, the Late group contained a significantly larger proportion of patients who identified as non-white (p=0.03), qualified for need-based financial assistance (p=0.03), were born preterm (p<0.01), or carried a comorbid diagnosis (p<0.01). Based on pre-operative testing, the Late group contained a significantly larger proportion of patients with baseline cognitive delays relative to the Early group (p=0.011).
Conclusion: This study demonstrates that socioeconomic disadvantages and comorbid diagnoses are associated with delayed cranial vault remodeling and may represent a selection bias toward slowed neurocognitive development. Future studies evaluating the relationship between surgical timing and neurocognitive development must consider confounders and selection biases.


Back to 2022 Abstracts


Miami
Miami
Miami
Miami