Complicated Acute Rhinosinusitis in Cystic Fibrosis: National Inpatient Pediatric Analysis

Background No prior national-level hospital admission analysis has compared acute rhinosinusitis (ARS) outcomes between cystic fibrosis (CF) and non-CF pediatric patients, leaving clinicians without population-level data to contextualize hospitalization burden and complication rates in this group. Objective We aimed to compare the complication risks and healthcare utilization between patients with CF versus without CF in children hospitalized with ARS. Methods The study examined inpatient admissions for pediatric ARS patients with or without CF in 2003-2019 using the Kids’ Inpatient Database (KID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Outcomes included orbital complications, intracranial complications, sinus involvement, sinus procedure rates, length of stay, and hospital charges. Results Of the weighted 41,148 patients with ARS, 1.5% had CF (n = 632). CF patients had lower odds of orbital complications (aOR 0.09, 95% CI 0.04-0.20, P < .001) but higher odds of sinus procedures (aOR 1.59, 95% CI 1.14-2.20, P = .006) compared to non-CF patients. CF patients also had longer hospital stays (8 vs 3 days, P < .001) and higher hospital charges ($43,918 vs $11,129, P < .001) compared to non-CF patients. Conclusion Children with concurrent CF and ARS experience greater overall disease burden, reflected in prolonged hospitalization, higher healthcare costs, and higher rates of sinus surgeries. However, CF patients appear less prone to orbital complications.