{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T02:32:17Z","timestamp":1792549937156,"version":"4.5.0"},"reference-count":39,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"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":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To identify factors associated with late cleft repair at a US tertiary children\u2019s hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective study of children with CL\/P using Children\u2019s Hospital Los Angeles (CHLA) records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>US tertiary children\u2019s hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Participants:<\/jats:title>\n                    <jats:p>Patients undergoing primary CL or CP repair at CHLA from 2009 to 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>Proportion of children who had delayed primary CL repair or CP repair using CHLA and American Cleft Palate-Craniofacial Association (ACPA) guidelines and factors associated with late surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 805 patients\u2014503 (62.5%) who had CL repair, 302 (37.5%) CP repair\u2014were included. Using CHLA protocol, 14.3% of patients seeking CL repair had delayed surgery. Delay was significantly associated with female gender, non-Hispanic ethnicity, Spanish primary language, government insurance, bilateral cleft, cleft lip and palate (CLP), and syndromic diagnosis. Using ACPA guidelines, 5.4% had delayed surgery. Female gender and syndromic diagnosis were significantly associated with delay and remained significant after adjustment for confounders in multivariate models. For CP repair, 60.3% of patients had delayed surgery using CHLA protocol. Cleft lip and palate diagnosis, complete cleft, syndromic diagnosis, and longer travel distance were significantly associated with delay. Using ACPA guidelines, 28.5% had delayed surgery; however, significant association with patient variables was not consistently observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Delay in cleft surgery occurs most often for patients seeking CP repair and is associated with female gender, non-Hispanic ethnicity, Spanish language, government insurance, and bilateral CL, CLP, or syndromic diagnoses. Initiatives should aim to optimize cleft surgery delivery for these subpopulations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665621989508","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T04:35:53Z","timestamp":1614659753000},"page":"1508-1516","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Factors Associated With Delay in Cleft Surgery at a Tertiary Children\u2019s Hospital in a Major US Metropolitan City"],"prefix":"10.1177","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5978-9339","authenticated-orcid":false,"given":"Jacqueline","family":"Stoneburner","sequence":"first","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2731-837X","authenticated-orcid":false,"given":"Naikhoba C. 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9967-8871","authenticated-orcid":false,"given":"Pedram","family":"Goel","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1340-3760","authenticated-orcid":false,"given":"Allyn","family":"Auslander","sequence":"additional","affiliation":[{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori K.","family":"Howell","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Oregon Health & Science University, School of Medicine, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey 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USA"},{"name":"Division of Plastic and Maxillofacial Surgery, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Division of Plastic and Reconstructive Surgery, Shriner\u2019s Hospital for Children, Pasadena, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"bibr1-1055665621989508","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.10.002"},{"issue":"15","key":"bibr2-1055665621989508","first-page":"15","volume":"12","author":"Adetayo O","year":"2012","journal-title":"Pan Afr Med J"},{"issue":"3","key":"bibr3-1055665621989508","first-page":"1","volume":"4","author":"Allam E","year":"2014","journal-title":"Anat 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