{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:58:49Z","timestamp":1791593929892,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Patients with cleft lip and\/or palate (CLP) are at increased risk of malnutrition. Acute and chronic malnutrition have been associated with elevated risk of postsurgical wound complications, adding morbidity and cost to patients and their families. To study the association between demographic factors, including insurance type, race, and median neighborhood income (MNI), and malnutrition in patients with CLP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review was performed in patients undergoing their first cleft\u2010related surgery at a large tertiary pediatric hospital from 2006 to 2018. Demographic data, weight and height at surgery, type of insurance, race, and primary residential address were collected. Geocoded information on MNI was generated using patient address. World Health Organization Z\u2010scores for weight\u2010for\u2010age (WFA) and height\u2010for\u2010age (HFA) were used as proxies for acute and chronic malnutrition, respectively. Linear regression models were generated to analyze the relationship of insurance type, race, and MNI on WFA and HFA Z\u2010scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 313 patients met inclusion criteria. Increasing MNI predicted increasing WFA Z\u2010score (0.05 increase in WFA per $1,000 increase,<jats:italic>P<\/jats:italic>\u00a0=\u00a0.047) as well as HFA Z\u2010score (0.09 increase in HFA per $1,000 increase,<jats:italic>P<\/jats:italic>\u00a0=\u00a0.011). The effect of MNI was not independently modified by race for either WFA (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.841) nor HFA (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.404). Race and insurance type did not predict WFA or HFA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lower MNI is a significant independent risk factor for acute and chronic malnutrition in children with CLP. Combined with previous investigation linking malnutrition to surgical outcomes in this population, this offers a target area for intervention to improve patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3<jats:italic>Laryngoscope<\/jats:italic>, 132:1482\u20131486, 2022<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29899","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T10:49:39Z","timestamp":1634813379000},"page":"1482-1486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Demographic Risk Factors for Malnutrition in Patients With Cleft Lip and Palate"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6867-0666","authenticated-orcid":false,"given":"Zahrah M.","family":"Taufique","sequence":"first","affiliation":[{"name":"ENT and Facial Plastic Surgery Children's Minnesota Minneapolis Minnesota U.S.A."},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Escher","sequence":"additional","affiliation":[{"name":"University of Minnesota School of Medicine Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3138-7469","authenticated-orcid":false,"given":"Tyler J.","family":"Gathman","sequence":"additional","affiliation":[{"name":"University of Minnesota School of Medicine Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Nickel","sequence":"additional","affiliation":[{"name":"Children's Research Institute Children's Minnesota Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B.","family":"Lee","sequence":"additional","affiliation":[{"name":"Amherst H. Wilder Foundation Saint Paul Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7244-3247","authenticated-orcid":false,"given":"Brianne B.","family":"Roby","sequence":"additional","affiliation":[{"name":"ENT and Facial Plastic Surgery Children's Minnesota Minneapolis Minnesota U.S.A."},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3966-3189","authenticated-orcid":false,"given":"Sivakumar","family":"Chinnadurai","sequence":"additional","affiliation":[{"name":"ENT and Facial Plastic Surgery Children's Minnesota Minneapolis Minnesota U.S.A."},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182402dd1"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrg2933"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618766058"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29209"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2019.09.016"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.4.e333"},{"key":"e_1_2_6_8_1","volume-title":"IPUMS National Historical Geographic Information System: Version 15.0 [dataset]","author":"Manson S","year":"2020"},{"key":"e_1_2_6_9_1","unstructured":"World Health Organization.WHO child growth standards. Available at:https:\/\/www.who.int\/childgrowth\/standards\/Technical_report.pdf. Accessed November 5 2020."},{"key":"e_1_2_6_10_1","unstructured":"World Health Organization.WHO child growth standards and the identification of severe acute malnutrition in infants and children. A Joint Statement by the World Health Organization and the United Nations Children's Fund. Available at:https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/44129\/9789241598163_eng.pdf?ua=1. Accessed November 5 2020."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12231"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00238-011-0620-z"},{"key":"e_1_2_6_13_1","unstructured":"World Health Organization.Anthropometric calculator version 3.1. Available at:www.who.int.childgrowth\/software\/en\/. Accessed September 28 2020."},{"key":"e_1_2_6_14_1","doi-asserted-by":"crossref","unstructured":"SchumacherD BorghiE PolonskyJ.anthro: Computation of the WHO child growth standards (R package). Available at:https:\/\/cran.rproject.org\/web\/packages\/anthro\/anthro.pdf. Accessed September 28 2020.","DOI":"10.32614\/CRAN.package.anthro"},{"key":"e_1_2_6_15_1","first-page":"661","article-title":"Development of a WHO growth reference for school\u2010aged children and adolescents","volume":"85","author":"Onis M","year":"2007","journal-title":"Bull World Health Organ"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1609535"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.2307\/2626958"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1215"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2009.36"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-9-53"},{"key":"e_1_2_6_21_1","unstructured":"United Nations Children's Fund World Health Organization and World Bank Group.Joint child malnutrition estimates 2017.WHO;2017. Available at:http:\/\/apps.who.int\/gho\/data\/node.wrapper.nutrition-2016. Accessed September 15 2020."},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.155.4.508"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.06.029"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-017-0327-6"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.014178"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-2432"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31826aac9b"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.55.2.111"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-010-9224-y"},{"key":"e_1_2_6_30_1","unstructured":"Minnesota Department of Human Services.Income and asset limits. Available at:https:\/\/mn.gov\/dhs\/people-we-serve\/adults\/health-care\/health-care-programs\/programs-and-services\/income-asset-limits.jsp. Accessed November 5 2020."},{"key":"e_1_2_6_31_1","unstructured":"Minnesota State Demographic Center.Income & poverty. Available at:https:\/\/mn.gov\/admin\/demography\/data-by-topic\/income-poverty. Accessed June 8 2021."},{"key":"e_1_2_6_32_1","unstructured":"ClayJ.Minnesota Cost of Living Study Annual Report 2016. Minnesota Department of Employment and Economic Development. Available at:https:\/\/www.leg.mn.gov\/docs\/2016\/mandated\/160558.pdf. Accessed June 8 2021."},{"key":"e_1_2_6_33_1","unstructured":"2018 Poverty guidelines.ASPE Available at:aspe.hhs.gov\/2018-poverty-guidelines. Accessed May 5 2021."},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0154535"},{"key":"e_1_2_6_35_1","unstructured":"2019 United States census quick facts. Available at:https:\/\/www.census.gov\/quickfacts\/fact\/table\/US\/PST045219. Accessed September 13 2021."}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29899","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29899","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T11:31:13Z","timestamp":1725967873000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,19]]},"references-count":34,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1002\/lary.29899"],"URL":"https:\/\/doi.org\/10.1002\/lary.29899","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,19]]},"assertion":[{"value":"2021-07-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}