title: Does Receiving a Blood Transfusion Predict for Length of Stay in Children Undergoing Cranial Vault Remodeling for Craniosynostosis? Outcomes Using the Pediatric National Surgical Quality Improvement Program Dataset.
abstract: OBJECTIVE
  Recent interventions have aimed at reducing the need for blood transfusions in the perioperative period in patients with craniosynostosis undergoing cranial vault remodeling. However, little is known regarding whether the receipt of a blood transfusion influences the length of hospital stay. The purpose of this study was to assess whether the receipt of a blood transfusion in patients undergoing cranial vault remodeling is associated with an increased length of stay.
  
  
  METHODS
  To address the research purposes, we designed a retrospective cohort study using the 2014 Pediatric National Surgical Quality Improvement Program (NSQIP Peds) dataset. The primary predictor variable was whether patients received a blood transfusion during cranial vault remodeling. The primary outcome variable was length of hospital stay after the operation. The association between the receipt of blood transfusions and length of stay was assessed using the Student t test. The association between other covariates and the outcome variable was assessed using linear regression, analysis of variance, and the Tukey test for post hoc pair-wise comparisons.
  
  
  RESULTS
  The sample was composed of 756 patients who underwent cranial vault remodeling: 503 who received blood transfusions and 253 who did not. The primary predictor variable of blood transfusion was associated with an increased length of stay (4.1 days vs 3.0 days, P = .03). Other covariates associated with an increased length of stay included race, American Society of Anesthesiologists status, premature birth, presence of a congenital malformation, and number of sutures involved in craniosynostosis.
  
  
  CONCLUSIONS
  The receipt of a blood transfusion in the perioperative period in patients with craniosynostosis undergoing cranial vault remodeling was associated with an increased length of stay.
authors.affiliation: Assistant Professor, Department of Oral & Maxillofacial Surgery, University of Illinois at Chicago, Attending Physician, Division of Oral and Maxillofacial Surgery, Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University Chicago, IL, Division of Dentistry, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: mrmark@uic.edu.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Markiewicz
authors.affiliation: Attending Physician, Neurosurgery; Chief Medical Informatics Officer; Assistant Professor, Pediatric Neurosurgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Tord
authors.initials: T
authors.lastname: Alden
authors.affiliation: Resident, Department of Oral & Maxillofacial Surgery, University of Illinois at Chicago, Chicago, IL.
authors.forename: Mohmed Vasim
authors.initials: MV
authors.lastname: Momin
authors.affiliation: Chief and Clinical Professor, Division of Oral and Maxillofacial Surgery, Department of Otolaryngology-Head and Neck Surgery; Feinberg School of Medicine, Northwestern University, Division of Dentistry, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
authors.forename: Alexis B
authors.initials: AB
authors.lastname: Olsson
authors.affiliation: Head, Division of Dentistry, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Ray J
authors.initials: RJ
authors.lastname: Jurado
authors.affiliation: Vice-Chair, Department of Surgery; Head, Division of Pediatric Surgery; Program Director, Fellowship in Pediatric Surgery; Professor of Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Fizan
authors.initials: F
authors.lastname: Abdullah
authors.affiliation: Professor and Head, Department of Oral & Maxillofacial Surgery, University of Illinois at Chicago, Clinical Professor, Division of Oral and Maxillofacial Surgery, Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University Chicago, IL.
authors.forename: Michael
authors.initials: M
authors.lastname: Miloro
mesh_terms: D001803:Blood Transfusion; D015331:Cohort Studies; D003398:Craniosynostoses / Q000601:surgery*; D066264:Datasets as Topic; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D058996:Quality Improvement; D012189:Retrospective Studies; D016896:Treatment Outcome