{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:43:01Z","timestamp":1777524181224,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T00:00:00Z","timestamp":1513209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Routine hospital admission following pharyngeal flap (PF) to correct velopharyngeal insufficiency (VPI) is the standard at most hospitals. Nevertheless, there is increasing resistance from third-party providers to approve stays longer than a \u201cshort stay\u201d (23-hour) observation period. The purpose of the current study was to evaluate length of stay (LOS) and document potential influencing factors following PF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective chart review. Demographic and perioperative data were collected, and statistical analyses were performed to determine associations with hospital length of stay (LOS). Readiness for discharge was determined by oral intake, analgesic requirement, and respiratory status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Tertiary care children\u2019s hospital<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>All patients undergoing PF for VPI between 1990 and 2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures:<\/jats:title>\n                    <jats:p>(1) LOS, (2) % satisfying all discharge criteria within a 23-hour observational time frame.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seventy-five patients were studied, with an average age of 6.8 years. Mean LOS was 65.4 hours. Only 11 patients (14.9%) met all discharge criteria by 23 hours. Multivariate predictors of shorter LOS were increasing patient age, male gender, lack of syndromic association, administration of an intraoperative antiemetic and steroids, and shorter anesthetic duration. Time to first oral intake correlated positively with LOS. Administration of intraoperative antiemetics increased the odds of meeting all discharge criteria within 23 hours by a factor of 12.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Identification of factors associated with LOS after PF may allow providers to predict and potentially mitigate hospital stays. Nevertheless, most patients undergoing PF are not clinically ready for discharge within a short-stay (23-hour) observation period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665617732776","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T13:03:16Z","timestamp":1518526996000},"page":"362-368","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Factors Predicting Hospital Length of Stay Following Pharyngeal Flap for Velopharyngeal Insufficiency"],"prefix":"10.1177","volume":"55","author":[{"given":"Jerry W.","family":"Chao","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s National Medical Center, Washington, DC, USA"},{"name":"George Washington University School of Medicine & Health Sciences, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Boyajian","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s National Medical Center, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard L.","family":"Amdur","sequence":"additional","affiliation":[{"name":"George Washington University School of Medicine & Health Sciences, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin J.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary F.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s National Medical Center, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert K.","family":"Oh","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s National Medical Center, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,12,14]]},"reference":[{"key":"bibr1-1055665617732776","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181bcf305"},{"key":"bibr2-1055665617732776","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2002_039_0145_aofpao_2.0.co_2"},{"key":"bibr3-1055665617732776","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000221468.54751.09"},{"key":"bibr4-1055665617732776","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20151002-52"},{"key":"bibr5-1055665617732776","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24706"},{"key":"bibr6-1055665617732776","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000100806.45065.35"},{"key":"bibr7-1055665617732776","unstructured":"Centers for Medicare and Medicaid Services. 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