Health-Related Quality of Life and the Desire for Revision Surgery Among Children With Cleft Lip and Palate

Kavitha Ranganathan, Danielle Shapiro, Oluseyi Aliu, Christian J. Vercler, Michaella Baker, Steven J. Kasten, Seth A. Warschausky, Steven R. Buchman, Jennifer F. Waljee

Research output: Contribution to journalArticle

Abstract

PURPOSE:: Children with cleft lip with or without palate (CLCP) require multiple reconstructive procedures, however, little is known about their desire for surgical revision. The purpose of this study was to examine the relationship between health-related quality of life (HRQOL) and the desire for revision. METHODS:: The authors surveyed children with CLCP (n?=?71) and their caregivers regarding general and cleft-specific HRQOL and the desire for revision surgery. The authors used logistic regression models to evaluate the relationship between HRQOL and the desire for revision stratified by age, and determined the level of agreement between caregivers and children. RESULTS:: In this cohort, 54.9% of children desired revision, primarily of the nose (n?=?23), lip (n?=?20), and dentoalveolar structures (n?=?19). Children 11 years or older were more likely to desire revision than younger children (OR 3.39, 95% CI [1.19, 9.67], P?<0.05). Children who reported poorer HRQOL with respect to appearance (OR 2.31, 95% CI [1.25–4.29], P?=?0.008), social development (OR 0.91, 95% CI [0.84–0.99], P?=?0.02), and communication (OR 0.94, 95% CI [0.89–0.99], P?=?0.02) were significantly more likely to desire revision than children who reported more positive HRQOL. Caregivers’ and childrenʼs desires for revision were only modestly correlated (r?=?0.41). CONCLUSIONS:: Children with CLCP who report poorer HRQOL are more likely to desire revision than children with higher HRQOL; these differences are further magnified among older children. Given the modest correlation between patient and caregiver goals for revision, it is important to evaluate both perspectives when considering revision surgery.

Original languageEnglish (US)
JournalJournal of Craniofacial Surgery
DOIs
StateAccepted/In press - Jul 26 2016

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Cleft Lip
Cleft Palate
Reoperation
Quality of Life
Caregivers
Logistic Models
Palate
Lip
Nose
Communication

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Health-Related Quality of Life and the Desire for Revision Surgery Among Children With Cleft Lip and Palate. / Ranganathan, Kavitha; Shapiro, Danielle; Aliu, Oluseyi; Vercler, Christian J.; Baker, Michaella; Kasten, Steven J.; Warschausky, Seth A.; Buchman, Steven R.; Waljee, Jennifer F.

In: Journal of Craniofacial Surgery, 26.07.2016.

Research output: Contribution to journalArticle

Ranganathan, Kavitha ; Shapiro, Danielle ; Aliu, Oluseyi ; Vercler, Christian J. ; Baker, Michaella ; Kasten, Steven J. ; Warschausky, Seth A. ; Buchman, Steven R. ; Waljee, Jennifer F. / Health-Related Quality of Life and the Desire for Revision Surgery Among Children With Cleft Lip and Palate. In: Journal of Craniofacial Surgery. 2016.
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abstract = "PURPOSE:: Children with cleft lip with or without palate (CLCP) require multiple reconstructive procedures, however, little is known about their desire for surgical revision. The purpose of this study was to examine the relationship between health-related quality of life (HRQOL) and the desire for revision. METHODS:: The authors surveyed children with CLCP (n?=?71) and their caregivers regarding general and cleft-specific HRQOL and the desire for revision surgery. The authors used logistic regression models to evaluate the relationship between HRQOL and the desire for revision stratified by age, and determined the level of agreement between caregivers and children. RESULTS:: In this cohort, 54.9{\%} of children desired revision, primarily of the nose (n?=?23), lip (n?=?20), and dentoalveolar structures (n?=?19). Children 11 years or older were more likely to desire revision than younger children (OR 3.39, 95{\%} CI [1.19, 9.67], P?<0.05). Children who reported poorer HRQOL with respect to appearance (OR 2.31, 95{\%} CI [1.25–4.29], P?=?0.008), social development (OR 0.91, 95{\%} CI [0.84–0.99], P?=?0.02), and communication (OR 0.94, 95{\%} CI [0.89–0.99], P?=?0.02) were significantly more likely to desire revision than children who reported more positive HRQOL. Caregivers’ and childrenʼs desires for revision were only modestly correlated (r?=?0.41). CONCLUSIONS:: Children with CLCP who report poorer HRQOL are more likely to desire revision than children with higher HRQOL; these differences are further magnified among older children. Given the modest correlation between patient and caregiver goals for revision, it is important to evaluate both perspectives when considering revision surgery.",
author = "Kavitha Ranganathan and Danielle Shapiro and Oluseyi Aliu and Vercler, {Christian J.} and Michaella Baker and Kasten, {Steven J.} and Warschausky, {Seth A.} and Buchman, {Steven R.} and Waljee, {Jennifer F.}",
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T1 - Health-Related Quality of Life and the Desire for Revision Surgery Among Children With Cleft Lip and Palate

AU - Ranganathan, Kavitha

AU - Shapiro, Danielle

AU - Aliu, Oluseyi

AU - Vercler, Christian J.

AU - Baker, Michaella

AU - Kasten, Steven J.

AU - Warschausky, Seth A.

AU - Buchman, Steven R.

AU - Waljee, Jennifer F.

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N2 - PURPOSE:: Children with cleft lip with or without palate (CLCP) require multiple reconstructive procedures, however, little is known about their desire for surgical revision. The purpose of this study was to examine the relationship between health-related quality of life (HRQOL) and the desire for revision. METHODS:: The authors surveyed children with CLCP (n?=?71) and their caregivers regarding general and cleft-specific HRQOL and the desire for revision surgery. The authors used logistic regression models to evaluate the relationship between HRQOL and the desire for revision stratified by age, and determined the level of agreement between caregivers and children. RESULTS:: In this cohort, 54.9% of children desired revision, primarily of the nose (n?=?23), lip (n?=?20), and dentoalveolar structures (n?=?19). Children 11 years or older were more likely to desire revision than younger children (OR 3.39, 95% CI [1.19, 9.67], P?<0.05). Children who reported poorer HRQOL with respect to appearance (OR 2.31, 95% CI [1.25–4.29], P?=?0.008), social development (OR 0.91, 95% CI [0.84–0.99], P?=?0.02), and communication (OR 0.94, 95% CI [0.89–0.99], P?=?0.02) were significantly more likely to desire revision than children who reported more positive HRQOL. Caregivers’ and childrenʼs desires for revision were only modestly correlated (r?=?0.41). CONCLUSIONS:: Children with CLCP who report poorer HRQOL are more likely to desire revision than children with higher HRQOL; these differences are further magnified among older children. Given the modest correlation between patient and caregiver goals for revision, it is important to evaluate both perspectives when considering revision surgery.

AB - PURPOSE:: Children with cleft lip with or without palate (CLCP) require multiple reconstructive procedures, however, little is known about their desire for surgical revision. The purpose of this study was to examine the relationship between health-related quality of life (HRQOL) and the desire for revision. METHODS:: The authors surveyed children with CLCP (n?=?71) and their caregivers regarding general and cleft-specific HRQOL and the desire for revision surgery. The authors used logistic regression models to evaluate the relationship between HRQOL and the desire for revision stratified by age, and determined the level of agreement between caregivers and children. RESULTS:: In this cohort, 54.9% of children desired revision, primarily of the nose (n?=?23), lip (n?=?20), and dentoalveolar structures (n?=?19). Children 11 years or older were more likely to desire revision than younger children (OR 3.39, 95% CI [1.19, 9.67], P?<0.05). Children who reported poorer HRQOL with respect to appearance (OR 2.31, 95% CI [1.25–4.29], P?=?0.008), social development (OR 0.91, 95% CI [0.84–0.99], P?=?0.02), and communication (OR 0.94, 95% CI [0.89–0.99], P?=?0.02) were significantly more likely to desire revision than children who reported more positive HRQOL. Caregivers’ and childrenʼs desires for revision were only modestly correlated (r?=?0.41). CONCLUSIONS:: Children with CLCP who report poorer HRQOL are more likely to desire revision than children with higher HRQOL; these differences are further magnified among older children. Given the modest correlation between patient and caregiver goals for revision, it is important to evaluate both perspectives when considering revision surgery.

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