Age-Related Differences and Determinants of Hospital Charges for Orbital Cellulitis in Texas

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.