Factors Associated with Delayed Palatoplasty Before, During, and After the COVID-19 Pandemic.
Factors Associated with Delayed Palatoplasty Before, During, and After the COVID-19 Pandemic.
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COVID-19 大流行之前、期间和之后与延迟腭成形术相关的因素。
DOI：
10.1097/scs.0000000000010065
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Kirschner,RichardE
中科院分区：
文献类型：
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作者：
Khansa,Ibrahim;Pollard,SarahHatch;Fogolin,Alyssa;Baylis,Adriane;Sitzman,ThomasJ;Chapman,KathyL;Kirschner,RichardE
背景：在美国，腭裂整形术通常在10到12个月大的时候进行，延迟会对语言发育产生负面影响。在新冠肺炎期间的早期，选择性手术被取消。这项研究的目的是(1)找出年龄较大的腭裂成形术的总体危险因素，(2)分析COVID-19期间腭裂成形术中的延迟。方法：这项研究是一项更大规模的前瞻性多中心比较研究的一部分。参与者于2019年3月至2022年9月在美国18家儿科医院接受了腭裂成形术。对早产儿的年龄进行了校正。根据流行的不同阶段，将腭裂成形术的日期分为4个时期。分析的因素包括地区、语言、收养状况、性别、民族、种族、农村、医疗保险类型和唇裂类型。采用单因素方差分析、学生检验和多元线性回归分析，P值为≤0.0 5。结果：共纳入研究对象928人。平均矫正年龄为374天。在单变量分析中，拉美裔儿童(P=0.003)、非白人、黑人或亚裔儿童(P<；0.001)和没有私人保险的儿童(P<；0.001)接受腭裂成形术的时间较晚。在多变量回归分析中，西班牙裔(P=0.015)、其他种族(P<；0.001)和没有私人保险(P<；0.001)是推迟腭裂成形术的预测因素。在新冠肺炎期间，女性、其他种族、来自非农村地区和接受医疗保险的患者出现了不成比例的延迟。其中一些人也受到了新冠肺炎延迟的不成比例的影响。提供者应该意识到这些差异，因为它们与公平获得头面部护理有关。证据级别：IIICopyright©2024作者：Mutaz B.Habal，MD订阅者的完整文本访问：
Background:Cleft palatoplasty is typically performed around 10 to 12 months of age in the US, and delays can negatively affect speech development. Early during COVID-19, elective surgeries were canceled. The aims of this study were to (1) identify overall risk factors for greater age at palatoplasty and (2) analyze delays in palatoplasty during COVID-19.Methods:This study was part of a larger prospective, multicenter comparative study of speech outcomes in palatoplasty. Participants underwent palatoplasty between March 2019 and September 2022 at 18 pediatric hospitals in the United States. Ages were corrected for prematurity. Dates of palatoplasty were divided into 4 periods corresponding to different phases of the pandemic. Factors analyzed included region, language, adoption status, sex, ethnicity, race, rurality, health insurance type, and cleft type. Analyses were performed using ANOVA, Student’s test, and multivariable linear regression, with a P value of≤ 0.05 being significant.Results:Nine hundred twenty-eight participants were included. Average corrected age at palatoplasty was 374 days. In univariable analysis, palatoplasty was performed later in children who were Hispanic (P= 0.003), of a race other than White, Black, or Asian (P< 0.001), and without private insurance (P< 0.001). On multivariable regression, predictors of delayed palatoplasty were Hispanic ethnicity (P= 0.015), from other race (P< 0.001), and without private insurance (P< 0.001). During COVID-19, disproportionate delays occurred in patients who were female, of other races, from nonrural areas, and on Medicaid.Conclusions:Palatoplasty was performed later in vulnerable populations. Some of these populations were also disproportionately affected by COVID-19 delays. Providers should be aware of these differences as they pertain to equitable access to craniofacial care.Level of Evidence:IIICopyright© 2024 by Mutaz B. Habal, MDFull Text Access for Subscribers: