Unbound MEDLINE

Orbital and periorbital infections: a national perspective.

Abstract

OBJECTIVES
To describe the epidemiologic features of pediatric orbital and periorbital infections from a national perspective and to identify predictors of surgery.
DESIGN
Analysis of the Kids' Inpatient Database.
SETTING
Administrative data set.
PATIENTS
Pediatric inpatient admissions with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis of orbital cellulitis.
MAIN OUTCOME MEASURES
Hospital admission, socioeconomic, and clinical variables were examined and predictors of surgical intervention were evaluated using logistic regression.
RESULTS
A total 5440 hospital admissions was noted for pediatric orbital cellulitis; of these, 672 patients (12.4%) underwent surgical intervention. Mean length of stay for all patients was 3.8 days; 90.4% were routinely discharged. Patients who had surgery were older, with a mean (SE) age of 10.1 (0.29) years compared with 6.1 (0.10) years for nonsurgical patients (P < .001). Surgical patients had a significantly longer mean hospital stay (7.1 vs 3.4 days, P < .001) and a higher mean cost of care ($41 009 vs $13 008, P < .001) compared with nonsurgical patients. Demographic predictors of surgical intervention included male sex, admitting characteristics, and hospital location. Except for sex, these variables remained significant in a multivariate model. Clinically, diplopia is a predictor of surgical intervention (odds ratio, 6.3; 95% confidence interval, 3.4-11.7).
CONCLUSIONS
This study describes the medical and surgical management of pediatric orbital and periorbital infections from a national perspective. Predictors of surgical intervention include older age, presentation with diplopia, and hospital admission via the emergency department. Knowledge of these variables facilitates analysis of resource utilization for pediatric orbital cellulitis and can be used to optimally triage patients, ultimately reducing costs and lengths of stay while preserving quality of care.

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  • Publisher Full Text
  • Authors

    Mahalingam-Dhingra A, Lander L, Preciado DA, Taylormoore J, Shah RK

    Institution

    Department of Economics, Yale University, New Haven, Connecticut, USA.

    Source

    Archives of otolaryngology--head & neck surgery 137:8 2011 Aug pg 769-73

    MeSH

    Age Factors
    Child
    Diplopia
    Female
    Hospitalization
    Humans
    Length of Stay
    Male
    Orbital Cellulitis
    Sex Factors
    Triage
    United States

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    21844410