Hospital utilization for orbital and intracranial complications of pediatric acute rhinosinusitis

Dylan A. Levy*, Shaun A. Nguyen, Richard Harvey, Claire Hopkins, Rodney J. Schlosser

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Orbital and intracranial complications of pediatric acute rhinosinusitis (ARS) are uncommon. With a risk of significant morbidity, hospital utilization and the financial burden of these entities are often high. We sought to assess utilization trends for complicated ARS and elucidate which factors influence cost. Methodology: Analysis of Kids’ Inpatient Database (2006, 2009 and 2012). Children were selected based on diagnosis codes for ARS and grouped as: uncomplicated ARS, orbital complications (OC), or intracranial complications (IC). Patients with IC were subdivided into abscess (ICa), meningitis, or sinus thrombosis. Length of stay (LOS), cost and management information were analysed. Data presented as median [IQR]. Results: A weighted total of 20,775 children were included. OC and IC were observed in 10.9% and 2.7% of these patients. LOS was longer for IC compared to OC (9 [8] v 4 [3]days, p < 0.001). Daily cost for IC was greater than OC ($2861 [4044] v $1683 [1187], p < 0.001), likely due to differences in need for surgery (IC 66.3% v OC 37.1%, p < 0.001). Within the ICa group, patients who received both otolaryngologic (ENT) and neurosurgery, compared to neurosurgery alone, had higher total cost ($41,474 [41,976] v $32,299 [18,235], p < 0.001) but similar LOS (12 [10] v 11 [9] days, p = 0.783). Conclusions: Children with IC required more surgery than their OC counterparts, resulting in a longer LOS and increased cost. Within the ICa group, the addition of ENT surgery to neurosurgery resulted in higher costs, but with a similar LOS. Considering the increased costs, the additional benefit of ENT surgery to those with children with IC should be investigated further.

Original languageEnglish
Article number109696
Pages (from-to)1-7
Number of pages7
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume128
DOIs
Publication statusPublished - 1 Jan 2020

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Keywords

  • Child
  • Child health services/economics
  • Complicated sinusitis
  • Cost-benefit analysis
  • Databases
  • Factual
  • Health resources/statistics & numerical data
  • Intracranial abscess
  • Intracranial infection
  • Length of stay
  • Orbital infection
  • Sinusitis complications
  • Sinusitis/economics
  • Sinusitis/therapy

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