Understanding Complications of Sinusitis in Paediatric Patients With Autism: A KID Database Study

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.