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Racial Differences in Evaluation and Management of Patients with Non-Syndromic Craniosynostosis
Tompkins-Rhoades, C.
Anstadt, E.
Marji, F. P.
Goldstein, J.
University of Pittsburgh School of Medicine
2020-02-14
Presenter: Casey Tompkins-Rhoades
Affidavit:
Work is accurate and original.
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Craniosynstosis is the premature fusion of the bony plates of an infant's skull. Untreated, this condition can lead to increased intracranial pressure, cognitive impairment, vision problems, and abnormal speech and hearing. These sequelae can be abated or avoided with early recognition of symptoms and referral for intervention.
A retrospective chart review of patients with craniosynostosis who were evaluated between 2012 and 2017 within the Division of Pediatric Plastic Surgery at a tertiary pediatric hospital was performed. Demographics, clinical history and radiologic data were recorded. Outcomes assessed include age at diagnostic imaging scan and age at definitive treatment. Statistical analysis was performed to analyze differences observed in Black or African-American patients compared to Caucasian patients.
A total of 218 patients were included. 99 identify as Black or African-American and 119 Caucasian. There was a statistically significant difference in mean age at diagnostic head CT between Caucasian and Black or African-American patients, 2.09 years versus 4.02 years respectively (p=0.011). For the Black or African-American patients that went on to receive surgical intervention (n=24, 24%), the mean age at the time of surgery was 2.51 years compared to 2.67 years for Caucasian patients. No significant difference was detected in average age at surgical intervention between the two cohorts (p=0.847).
Diagnostic imaging is a critical component of the evaluation of patients with craniosynostosis. Our data suggest systematic barriers to this evaluation and diagnosis exist in this population. Further studies to determine why this population is experiencing delayed access to care is necessary.
