Trend of surgery for orbital cellulitis: An analysis of state inpatient databases

Pawina Jiramongkolchai, Daniel P. Lander, Dorina Kallogjeri, Margaret A. Olsen, Matthew Keller, John S. Schneider, Jake J. Lee, Kim Jiramongkolchai, Jay F. Piccirillo

Research output: Contribution to journalArticle

Abstract

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, 2019.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StatePublished - Jan 1 2019

Fingerprint

Orbital Cellulitis
Inpatients
Databases
International Classification of Diseases
Hospitalization
Logistic Models
Abducens Nerve
Oculomotor Nerve
Laryngoscopes
Optic Neuritis
Optic Nerve
Insurance
Paralysis
Comorbidity
Edema

Keywords

  • Orbital cellulitis
  • state inpatient database
  • surgical trends

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Jiramongkolchai, P., Lander, D. P., Kallogjeri, D., Olsen, M. A., Keller, M., Schneider, J. S., ... Piccirillo, J. F. (2019). Trend of surgery for orbital cellulitis: An analysis of state inpatient databases. Laryngoscope. https://doi.org/10.1002/lary.28050

Trend of surgery for orbital cellulitis : An analysis of state inpatient databases. / Jiramongkolchai, Pawina; Lander, Daniel P.; Kallogjeri, Dorina; Olsen, Margaret A.; Keller, Matthew; Schneider, John S.; Lee, Jake J.; Jiramongkolchai, Kim; Piccirillo, Jay F.

In: Laryngoscope, 01.01.2019.

Research output: Contribution to journalArticle

Jiramongkolchai, P, Lander, DP, Kallogjeri, D, Olsen, MA, Keller, M, Schneider, JS, Lee, JJ, Jiramongkolchai, K & Piccirillo, JF 2019, 'Trend of surgery for orbital cellulitis: An analysis of state inpatient databases', Laryngoscope. https://doi.org/10.1002/lary.28050
Jiramongkolchai P, Lander DP, Kallogjeri D, Olsen MA, Keller M, Schneider JS et al. Trend of surgery for orbital cellulitis: An analysis of state inpatient databases. Laryngoscope. 2019 Jan 1. https://doi.org/10.1002/lary.28050
Jiramongkolchai, Pawina ; Lander, Daniel P. ; Kallogjeri, Dorina ; Olsen, Margaret A. ; Keller, Matthew ; Schneider, John S. ; Lee, Jake J. ; Jiramongkolchai, Kim ; Piccirillo, Jay F. / Trend of surgery for orbital cellulitis : An analysis of state inpatient databases. In: Laryngoscope. 2019.
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abstract = "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, 2019.",
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