{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:09:00Z","timestamp":1784761740243,"version":"3.55.0"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1,1]]},"abstract":"\n OBJECTIVES:<\/jats:title>\n To describe variation in the care of children hospitalized with orbital cellulitis and to determine associations with length of stay (LOS), emergency department (ED) revisits, and hospital readmissions.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n By using the Pediatric Health Information System, we performed a multicenter, retrospective study of children aged 2 months to 18 years with a primary International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis code for orbital cellulitis from 2007 to 2014. We assessed hospital-level variation in the use of diagnostic tests, corticosteroids, and antibiotics individually and in aggregate for association with outcomes (LOS, ED revisits, readmissions) after risk-adjusting for important clinical and demographic factors.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n A total of 1828 children met inclusion criteria. Complete blood cell counts (median [interquartile range]: 81.8% [66.7\u201389.6]), C-reactive protein levels (57.1% [22.2\u201384.0]), blood cultures (57.9% [48.9\u201363.6]), and computed tomography imaging (74.7% [66.7\u201381.0]) were the most frequently performed diagnostic tests, with significant variation observed across hospitals (all P &lt; .001). Corticosteroids were used in 29.2% of children (interquartile range: 18.4\u201337.5). There was significant variation in antibiotic exposure across hospitals (P &lt; .001). Increased total diagnostic test usage was associated with increased LOS (P = .044), but not with 30-day ED revisits (P = .176) or readmissions (P = .403).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Children hospitalized with orbital cellulitis experience wide variation in clinical management. Increased hospital-level usage is associated with increased LOS. Our findings highlight a critical need to identify treatment strategies that optimize resource use and outcomes for children hospitalized with orbital cellulitis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/hpeds.2017-0040","type":"journal-article","created":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T09:30:19Z","timestamp":1514799019000},"page":"28-35","source":"Crossref","is-referenced-by-count":38,"title":["Variation in Care and Clinical Outcomes in Children Hospitalized With Orbital Cellulitis"],"prefix":"10.1542","volume":"8","author":[{"given":"Jessica L.","family":"Markham","sequence":"first","affiliation":[{"name":"Divisions of Pediatric Hospital Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hall","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Hospital Medicine and"},{"name":"Children\u2019s Hospital Association, Lenexa, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Bettenhausen","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Hospital Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela L.","family":"Myers","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Hospital Medicine and"},{"name":"Infectious Diseases, Children\u2019s Mercy Kansas City, Kansas City, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry T.","family":"Puls","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Hospital Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell J.","family":"McCulloh","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Hospital Medicine and"},{"name":"Infectious Diseases, Children\u2019s Mercy Kansas City, Kansas City, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2018,1,1]]},"reference":[{"issue":"6","key":"2021120817263054100_B1","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1046\/j.1440-1606.1999.00242.x","article-title":"Current treatment and outcome in orbital cellulitis","volume":"27","author":"Ferguson","year":"1999","journal-title":"Aust N Z J Ophthalmol"},{"issue":"2","key":"2021120817263054100_B2","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.ophtha.2006.07.059","article-title":"Outcome of treated orbital cellulitis in a tertiary eye care center in the middle East","volume":"114","author":"Chaudhry","year":"2007","journal-title":"Ophthalmology"},{"issue":"6","key":"2021120817263054100_B3","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1542\/pir.31-6-242","article-title":"Periorbital and orbital cellulitis","volume":"31","author":"Hauser","year":"2010","journal-title":"Pediatr Rev"},{"key":"2021120817263054100_B4","unstructured":"Agency for Healthcare Research and Quality. 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