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Race is associated with Delayed Diagnosis of Sagittal Craniosynostosis: A Single-Institutional Retrospective Study
Maura Guyler BA,*
Susan J. Doh MD*
Klarens Menage MS
Krystal L. Tomei MD, MPH
Howard D. Wang, MD
Asterisks indicate co first authors
Case Western Reserve University School of Medicine
2025-01-08
Presenter: Maura Guyler
Affidavit:
Yes
Director Name: Howard D Wang
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Age at diagnosis can impact surgical technique for patients with sagittal craniosynostosis. This study aims to identify factors associated with delayed diagnosis in patients with sagittal craniosynostosis incorporating both clinical and sociodemographic variables.
Methods: A single institution retrospective study was performed on patients with sagittal craniosynostosis over 10 years. Variables collected included sex, race, ethnicity, age at diagnosis, insurance type, distance traveled, community designation and area deprivation index (ADI), cephalic index (CI), and prematurity (birth at gestational age < 37 weeks). Statistical analysis was performed with Fisher's exact test, Wilcoxon-sum test, and multivariable logistic regression.
Results: On univariate analysis, diagnosis >6 months of age was associated with a greater proportion of non-Hispanic Black patients (44% vs 8%, p< 0.001) and a smaller proportion of non-Hispanic White patients (39% vs 79%, p< 0.001). A greater proportion of patients had CI ≥ 75 (55% vs 6%, p < 0.001), and a greater proportion of patients had public insurance (68% vs 38%, p = 0.008). On multivariable logistic regression non-Hispanic Black patients were nearly 7 times more likely compared to non-Hispanic White patients to experience delayed diagnosis when controlling for national (OR 6.96, p = 0.018) or state ADI (OR 6.51, p = 0.039).
Conclusion: After adjusting for multiple clinical and sociodemographic factors including insurance type and CI, Black patients were nearly 7 times more likely than White patients to experience delayed diagnosis of sagittal craniosynostosis. Future studies are needed to identify modifiable factors contributing to this diagnosis gap.
