德克萨斯州眶蜂窝织炎住院费用的年龄相关差异及其决定因素

文献信息

中文摘要

目的： 评估德克萨斯州眶蜂窝织炎（OC）住院相关的人口学、临床和经济因素，特别关注儿童与成人患者之间的差异。
方法： 对德克萨斯州医院住院患者出院公共使用数据文件（2016-2020年）进行回顾性分析，评估ICD-10-CM编码提示OC诊断的住院患者。主要暴露因素为年龄（<18岁 vs. 至18岁）和手术干预。结局包括总住院费用和住院时间（LOS）。回归模型确定费用和LOS的预测因素（p < 0.05）。
结果： 在2,673例患者中，费用中位数为36,172.07美元，LOS中位数为4天。多变量分析显示，手术（相对均值比[RR] = 2.34）、择期入院（RR = 1.35）以及中度（RR = 1.29）、重度（RR = 3.00）或极重度（RR = 9.55）疾病严重程度与更高的平均费用相关。急诊入院降低费用（RR = 0.84）。儿童患者比成人更可能需要手术（22.4% vs. 9.6%；OR = 0.27）。然而，在手术病例中，成人的费用显著更低（回归系数[RC] = -0.26），住院时间也更短（RC = -0.22）。
结论： OC的经济负担与疾病严重程度和操作使用相关。尽管成人通常基线疾病严重程度更高，但儿童患者接受手术的比例过高，这可能增加LOS和住院费用。早期鼻窦炎管理对于预防手术干预需求和降低成本至关重要。

英文摘要

PURPOSE: To evaluate demographic, clinical, and economic factors associated with hospitalization for orbital cellulitis (OC) in Texas, with particular attention to differences between pediatric and adult patients.
METHODS: A retrospective analysis of the Texas Hospital Inpatient Discharge Public Use Data File (2016-2020) evaluated hospitalized patients with ICD-10-CM denoting a diagnosis of OC. Primary exposures were age (<18 vs. up to 18 years) and surgical intervention. Outcomes included total hospital charges and length of stay (LOS). Regression models identified predictors of cost and LOS (p < 0.05).
RESULTS: Among 2,673 patients, median charges were $36,172.07 and median LOS was 4 days. Multi-variable analysis showed higher mean charges with surgery (relative mean ratio [RR] = 2.34), elective admission (RR = 1.35), and moderate (RR = 1.29), major (RR = 3.00), or extreme (RR = 9.55) illness severity. Urgent admission lowered charges (RR = 0.84). Pediatric patients were more likely to require surgery than adults (22.4% vs. 9.6%; OR = 0.27). However, among surgical cases, adults had significantly lower charges (regression coefficient [RC] = ‑0.26) and shorter stays (RC = ‑0.22) than children.
CONCLUSION: Financial burden in OC is associated with illness severity and procedural use. Although adults often present with higher baseline disease severity, pediatric patients disproportionately undergo surgical procedures, which can increase LOS and hospital charges. Early sinusitis management is essential to prevent the need for surgical intervention and reduce costs.