Predictors for admission of children with periorbital cellulitis presenting to the pediatric emergency department

Pediatr Emerg Care. 2008 May;24(5):279-83. doi: 10.1097/PEC.0b013e31816ecb43.

Abstract

Objectives: To identify demographic and clinical characteristics associated with admission because of periorbital cellulitis (PC) in children.

Methods: Records of children aged 0 to 18 years with PC who visited our tertiary emergency department (ED) in 2004 were reviewed. We calculated a cumulative number of local ocular symptoms in patients that included swelling/edema, redness/erythema, presence of discharge, pain, conjunctival injection, and shut eye. A binary logistic regression analysis was performed to identify predictors of admission for PC.

Results: A total of 89 children were included in the analysis; 39 (44%) of them were admitted to the ward. A cumulative number of local symptoms associated with PC and temperature in the ED served as significant predictors of hospitalization (odds ratio, 2.5; P = 0.005; and odds ratio, 2.0; P = 0.04, respectively). Among individual local symptoms, only swelling/edema was found to significantly predict admission in univariate analysis (P = 0.03). Considerable variation was documented in intravenous and oral antibiotics prescribed in the ED.

Conclusions: Combination of local ocular symptoms and body temperature are positively associated with admission from the ED. Future research should concentrate on evaluating the suggested score we used in this cohort to validate it and evaluate its generalizability. Devising such scoring can help clinicians determine guidelines for admission of children with PC.

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Hospitalization / statistics & numerical data
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Male
  • Medical Records
  • Ontario
  • Orbital Cellulitis / classification
  • Orbital Cellulitis / drug therapy
  • Orbital Cellulitis / physiopathology*
  • Predictive Value of Tests
  • Severity of Illness Index

Substances

  • Anti-Bacterial Agents