Risk Factors for Infection, Dehiscence, and Unplanned Reintubation Following Cleft Lip Repair.

Abstract

ObjectiveWe sought to characterize factors associated with postoperative complications in patients undergoing primary cleft lip repair (CLR).DesignThe National Surgical Quality Improvement Program-Pediatric database was queried to identify patients under 12 months old undergoing CLR using CPT codes. Multivariable analysis was conducted to characterize complications and associated comorbidities.SettingA multicenter sample.Patients/ParticipantsA total of 11 957 cases (81.9% unilateral CLR and 18.1% bilateral CLR) were identified.InterventionsNone.Main Outcomes/MeasuresThe postoperative outcomes of significance were surgical site infection (SSI), wound dehiscence, and unplanned reintubation within 30 days of CLR.ResultsThe cohort had a mean age of 4.7 ± 2.0 months and a median American Society of Anesthesiologists classification of 2. SSIs occurred in 0.6% of cases and were independently associated with bilateral cleft anatomy (OR 2.16, P = .003) and longer anesthesia time (OR per minute: 1.004, P = .009). Wound dehiscence occurred in 0.4% of patients and was independently associated with bilateral cleft anatomy (OR 4.03, P < .001) but was associated with shorter anesthesia duration (OR per minute: 0.991, P < .001). Unplanned reintubation occurred in 0.2% of cases, with these patients having significantly higher rates of multiple comorbidities.ConclusionWound dehiscence, SSI, and unplanned reintubation were rare complications following CLR. Patients with a bilateral cleft lip had increased odds of both SSI and wound dehiscence.