TY - JOUR
T1 - Trend of surgery for orbital cellulitis
T2 - An analysis of state inpatient databases
AU - Jiramongkolchai, Pawina
AU - Lander, Daniel P.
AU - Kallogjeri, Dorina
AU - Olsen, Margaret A.
AU - Keller, Matthew
AU - Schneider, John S.
AU - Lee, Jake J.
AU - Jiramongkolchai, Kim
AU - Piccirillo, Jay F.
N1 - Funding Information:
This study was supported by the Development of Clinician/ Researchers in Academic ENT (T32 DC00022) from the National Institutes of Deafness and Other Communication Disorders and the Center for Administrative Data Research (CADR), part of the Washington University Institute of Clinical and Translational Sciences, which is supported by the National Institutes of Health (NIH)/National Center for Advancing Translational Sciences, Clinical and Translational Science Awards grant UL1TR002345. Support for the CADR was also provided in part by grant R24HS19455 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Funding Information:
The SIDs are part of a family of administrative databases developed by the Healthcare Cost and Utilization Project and maintained by the Agency for Healthcare Research and Quality. The SIDs contain comprehensive information on all inpatient discharge records from community hospitals for participating states regardless of payer. Hospital-specific characteristics were obtained from the American Hospital Association Annual Survey of Hospitals (Health Forum, Chicago, IL) and linked to SIDs data by hospital identifier. A retrospective study was performed using the SIDs for Arkansas (AR), Florida (FL), Iowa (IA), Maryland (MD), Nebraska (NE), New York (NY), and Wisconsin (WI). These seven states were chosen to provide a representative and comprehensive population of pediatric and adult patients.
Publisher Copyright:
© 2019 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Objectives/Hypothesis: To evaluate the trend and factors associated with surgical management of orbital cellulitis. Study Design: Retrospective database study. Methods: Study using the State Inpatient Databases (SIDs) from 2008 to 2015. Patients with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code for orbital cellulitis were identified in the SIDs for the following states: Arkansas, Florida, Iowa, Maryland, Nebraska, New York, and Wisconsin. Surgery was defined as an ICD-9-CM procedure code for orbitotomy and/or functional endoscopic sinus surgery. The trend of surgery over time was evaluated using the Cochran-Armitage test. Multivariable logistic regression models were used to identify patient- and hospital-level factors associated with surgery. Results: From 2008 to 2013, the number of hospitalizations for orbital cellulitis ranged from 1,349 to 1,574, but declined to 865 in 2014. From 2008 to 2015, the number of surgeries ranged from 103 to 154. For children (n = 3,041), age, ophthalmologic comorbidity, and conjunctival edema were significantly associated with surgery, whereas for adults (n = 7,961), male gender, private insurance, optic neuritis, and cranial nerves III/VI/VI palsy were associated with surgery. Conclusions: Although the number of inpatient hospitalizations for orbital cellulitis has markedly declined, the number of surgeries for orbital cellulitis has remained fairly stable, leading to an observed higher proportion of hospitalized patients undergoing surgery. Future directions include extending the time frame to the present day to assess current rates of hospitalization and surgery. Knowledge of surgical trends and patient- and hospital-level characteristics associated with surgery may help improve management guidelines for and understanding of this vision-threatening disease. Level of Evidence: NA. Laryngoscope, 130:567–574, 2020.
AB - Objectives/Hypothesis: To evaluate the trend and factors associated with surgical management of orbital cellulitis. Study Design: Retrospective database study. Methods: Study using the State Inpatient Databases (SIDs) from 2008 to 2015. Patients with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code for orbital cellulitis were identified in the SIDs for the following states: Arkansas, Florida, Iowa, Maryland, Nebraska, New York, and Wisconsin. Surgery was defined as an ICD-9-CM procedure code for orbitotomy and/or functional endoscopic sinus surgery. The trend of surgery over time was evaluated using the Cochran-Armitage test. Multivariable logistic regression models were used to identify patient- and hospital-level factors associated with surgery. Results: From 2008 to 2013, the number of hospitalizations for orbital cellulitis ranged from 1,349 to 1,574, but declined to 865 in 2014. From 2008 to 2015, the number of surgeries ranged from 103 to 154. For children (n = 3,041), age, ophthalmologic comorbidity, and conjunctival edema were significantly associated with surgery, whereas for adults (n = 7,961), male gender, private insurance, optic neuritis, and cranial nerves III/VI/VI palsy were associated with surgery. Conclusions: Although the number of inpatient hospitalizations for orbital cellulitis has markedly declined, the number of surgeries for orbital cellulitis has remained fairly stable, leading to an observed higher proportion of hospitalized patients undergoing surgery. Future directions include extending the time frame to the present day to assess current rates of hospitalization and surgery. Knowledge of surgical trends and patient- and hospital-level characteristics associated with surgery may help improve management guidelines for and understanding of this vision-threatening disease. Level of Evidence: NA. Laryngoscope, 130:567–574, 2020.
KW - Orbital cellulitis
KW - state inpatient database
KW - surgical trends
UR - http://www.scopus.com/inward/record.url?scp=85065450716&partnerID=8YFLogxK
U2 - 10.1002/lary.28050
DO - 10.1002/lary.28050
M3 - Article
C2 - 31050824
AN - SCOPUS:85065450716
SN - 0023-852X
VL - 130
SP - 567
EP - 574
JO - Laryngoscope
JF - Laryngoscope
IS - 3
ER -