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Racial Disparities Within Non-syndromic Craniosynostosis Diagnosis and Management
Christopher Fedor, Angel Dixon, Casey Zhang, Joseph Mocharnuk, Megan Pencek, MD, Nicolas M. Kass, Jesse Goldstein, MD
University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, UPMC Departmen
2024-01-15
Presenter: Christopher Fedor
Affidavit:
All authors made significant contributions to this project and are deserving of recognition for their work.
Director Name: Jesse Goldstein, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Patients with craniosynostosis require timely and coordinated care from primary care providers and specialized multidisciplinary teams to mitigate unfavorable consequences like elevated intracranial pressure and cognitive deficits. However, achieving equitable access to such intervention, particularly addressing disparities between Black and White patients, remains a global concern. This study aims to investigate potential discrepancies in diagnosis and management of non-syndromic craniosynostosis among racial groups in our patient population. We conducted a single-center retrospective analysis of 275 patients diagnosed with non-syndromic craniosynostosis at UPMC's Cleft-Craniofacial Clinic between 2017 and 2021. Demographics, referral status, age of diagnosis, radiological assessments, and surgical interventions were specifically evaluated and compared among White (n=238), Black (n=25), and Asian (n=3) identifying patients. No significant differences were found in the age of diagnosis, rates of CT imaging, or rates of surgical intervention among these demographic groups. For White, Black, and Asian patients, respectively, the median ages at first CT were 6.1, 13.9, and 5.3 months (p=0.07), and the median ages at surgical intervention were 9.6, 15.6, and 32.3 months (p=0.17). The average time between the first CT and surgery was 5.9, 11.4, and 15.2 months (p=0.25) for White, Black, and Asian patients, respectively. No other predictive associations between race and outcome measures were observed (logistic regression, p=0.62). While these data suggest that the multidisciplinary teams at our institution are delivering impartial care to craniosynostosis patients, further exploration of observed trends is warranted to address potential disparities, particularly as we narrow our studies to the neighborhood level.
