P83. LATE PRESENTATION OF NON-SYNDROMIC CRANIOSYNOSTOSIS: DOES SOCIOECONOMIC STATUS MATTER?

Abstract

PURPOSE: Non-syndromic craniosynostosis (NSC) patients can be treated before 12 months of age to attenuate difficulties associated with delayed care (e.g. more challenging/extensive surgery, greater risk of complications). NSC patients that undergo delayed treatment are not well characterized in the literature. This study aims to identify potential contributors to delayed care for late presenting (>12 months of age at primary surgery) NSC patients. METHODS: A retrospective review of patients who underwent primary surgery for late presenting NSC at a single institution. Data including ages at diagnosis and surgery, clinical features, and sociodemographic variables such as home zip code median household income (MHI) were analyzed. RESULTS: Eighty-three patients were included, with a median age at surgery of 580 days. Of these, 32 (39%) were diagnosed before 12 months of age. Black, Hispanic, and “other” races had a greater, though not significant, average time to surgery than White or Asian patients (p = 0.062). MHI ranged from $20,636-140,511 (median = $45,584), with a 100-day delay in surgery associated with each $10,000 decrease in MHI (p = 0.040). Suture involvement was not associated with surgical delay. CONCLUSION: The association between surgical delay and decreased MHI suggests that socioeconomic disparities may contribute to care gaps in late presenting NSC patients; anticipation of these characteristics can help surgeons in patient identification and management.