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The Synostosis Research Group (SynRG) Outcomes Study: Preliminary Results from a Multi-center, Prospective Consortium for the Study of Craniosynostosis Diagnosis and Treatment

Dvoracek LA1, Kestle JRW2, Lee A4, Anderson RCE5, Gociman B2, Patel KB3, Smyth MD3, Birgfeld C4, Pollack IF1, Tamber M6, Imahiyerobo T5, Siddiqi FA2, Goldstein JA1 1. Univ. of Pittsburgh 2. Univ. of Utah 3. Washington Univ. in St. Louis 4. Univ. of Washington 5. Columbia Univ. 6. Univ. of British Columbia
University of Pittsburgh
2019-02-13

Presenter: Lucas Dvoracek

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.

Director Name: Vu Nguyen

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

Introduction
Craniosynostosis (CS) treatment is complex and varies widely. Large-scale outcome studies are difficult given the practice variation, low incidence of disease, and long time between intervention and final outcome. Established in 2016, the Synostosis Research Group (SynNRG) is the largest multi-center consortium focused on prospectively evaluating the diagnosis and management of patients with CS. Here we present a preliminary analysis of these data.

Methods
IRB at each SynRG institution approved this study prior to data collection. Patients diagnosed with CS who presented to any of 5 institutions from 2017 to present were enrolled in this study. Clinical data in 276 categories were recorded prospectively.

Results
Of 298 patients registered, 62.7% were male. Average age at registration was 10.4 months. Single suture CS accounted for 80% of patients and multisutural 20%; 3% of patients were syndromic. Mean age at surgery was 11.3 months. 46% underwent open vault reconstruction (50.1% of these were fronto-orbital advancements) and 43% underwent strip craniectomy (66.2% were sagittal, 16.9% metopic, and 13.6% coronal).
Additional data include usage information for drains, antibiotics, tranexamic acid use, steroids, transfusion during and after surgery, in-hospital complications, length of stay, and narcotic prescribing practices.

Conclusion
Large, prospective, multicenter studies of CS treatment have the potential to identify opportunities to optimize care and improve outcomes. This preliminary analysis of the SynRG data reveals clear trends in treatment of CS and will be useful in improving outcomes moving forward as the consortium continues.

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