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Understanding Complications of Sinusitis in Paediatric Patients With Autism: A KID Database Study
Soumil Prasad1, Levi Travis1, Christine Mei1
1University of Miami Miller School of Medicine, Miami, Florida, USA.
Insights
Children with autism spectrum disorder (ASD) hospitalized for acute sinusitis face higher risks of seizures and orbital complications. They are also less likely to undergo necessary sinus surgeries, highlighting a need for specialized care.
Area of Science:
- Pediatric Otolaryngology
- Neurodevelopmental Disorders
- Infectious Disease Complications
Background:
- Acute sinusitis is common in children, but complication risks may differ in those with autism spectrum disorder (ASD).
- Understanding these risks is crucial for appropriate medical and surgical management.
Purpose of the Study:
- To compare the incidence of orbital and neurological complications in pediatric patients with acute sinusitis, stratified by ASD diagnosis.
- To evaluate differences in surgical interventions, length of stay, and costs between pediatric patients with and without ASD.
Main Methods:
- Retrospective cohort study using the 2019 Kids' Inpatient Database (KID).
- Identified pediatric patients with acute sinusitis, comparing those with ASD to neurotypical peers.
- Utilized propensity score matching (PSM) to control for confounding variables.
Main Results:
- Patients with ASD experienced higher rates of seizures (26.4% vs. 6.3%) and orbital complications (4% vs. 1.4%) compared to controls.
- ASD patients were less likely to undergo maxillary sinus surgery (OR=0.46).
- No significant differences were observed in length of stay or hospital costs.
Conclusions:
- Pediatric patients with ASD hospitalized for acute sinusitis exhibit an elevated risk for neurological complications like seizures.
- These children are less likely to receive certain surgical interventions, suggesting potential disparities in care.
- Findings emphasize the need for tailored neurological monitoring and investigation into surgical decision-making for pediatric sinusitis patients with ASD.
Objective:
This study evaluated the risk of orbital and neurological complications of acute sinusitis in pediatric patients with autism spectrum disorder (ASD) compared to neurotypical peers.
Study Design:
Retrospective cohort study.
Setting:
Analysis of data from the 2019 Kids' Inpatient Database (KID), a nationally representative sample of pediatric inpatient hospitalizations.
Methods:
Paediatric patients discharged with acute sinusitis were identified using ICD-10-CM codes and stratified by the presence of an ASD diagnosis. Primary outcomes included orbital complications (e.g., eye pain, chemosis, cellulitis, abscess) and neurological complications (e.g., seizures, meningitis, stroke). Secondary outcomes included surgical interventions, length of stay (LOS), and hospital costs. One-to-one propensity score matching (PSM) was performed to adjust for patient- and hospital-level factors.
Results:
Of 3763 hospitalised children with acute sinusitis, 125 (3.4%) had ASD. After matching, ASD patients had significantly higher rates of seizures (26.4% vs. 6.3%; OR = 3.52; p < 0.001) but were less likely to undergo maxillary sinus surgery (OR = 0.46; p = 0.037). Orbital complications, including eye pain, were more frequent in the ASD group (4% vs. 1.4%; p = 0.043). LOS and hospital costs did not differ significantly between groups after matching.
Conclusion:
Children with ASD hospitalized for acute sinusitis appear to be at higher risk for seizures but less likely to undergo certain sinus surgeries. These findings underscore the need for tailored neurological management and exploration of factors influencing surgical decisions in this population.
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