D85. ACS NSQIP Pediatric Database Cannot Estimatecraniosynostosis Incidence in the United States

PURPOSE: The goal of this study was to use NSQIP data as a surrogate for updated incidences of craniosynostosis in the United States. METHOD: The NSQIP Pediatric Database was queried from 2017-2021 for craniosynostosis-related CPT codes (61550, 61556, 61557, 61558, and 61559) and ICD-10 diagnosis code (Q75.0). Results were then logged for patients under two years of age to minimize the potential for capturing secondary surgery. RESULTS: Total calculated incidences were 1:2785 live births in 2021, 1:2884 live births in 2020, 1:3116 live births in 2019, 1:3587 live births in 2018, and 1:4286 live births in 2017. Additionally, the database captured 3116 cases performed for multiple suture craniosynostosis and 2,605 cases performed for single suture craniosynostosis. CONCLUSION: The results of this study underestimate the incidence of craniosynostosis in the United States over recent years. The lack of granularity in CPT and ICD codes is a significant impairment to understanding the true burden of the disease and its subsequent management. Additionally, our analysis found more procedures logged for multiple suture craniosynostosis, which is contradictory to known epidemiological studies that report single suture craniosynostosis being far more common. Large multi-institutional databases can provide powerful data, but are often streamlined for efficiency which can complicate analyses. Great care must be taken when using these tools for more than baseline analyses and primary investigations.