Resource utilization and outcomes of inpatient eyelid reconstruction in facial palsy patients: A 20-year HCUP-NIS study

Background: Facial palsy-related lagophthalmos can threaten ocular surface integrity and may require surgical eyelid management. Methods: We conducted a retrospective cross-sectional analysis of adult inpatients in the Healthcare Cost and Utilization Project National/Nationwide Inpatient Sample from 2002 to 2021 with facial nerve disorder diagnosis codes and concurrent ICD-coded eyelid procedures. Demographics, hospital characteristics, length of stay, discharge disposition, charges, complications, comorbidity burden, and age- and income-stratified differences were analyzed. Results: We identified 1,839 inpatients with a median age of 60 years; 48.0% were female. Median length of stay was 4 days, median charges were $48,696, and patients underwent a mean of 4.96 coded procedures per admission. Complications were coded in 26.7% of cases. Older patients had longer hospitalizations, greater comorbidity burden, and higher complication rates, but lower median charges. Among patients with available income data, low- and high-income groups had similar length of stay and charges, despite differences in race, payer status, and geographic distribution. Conclusions: Inpatients with facial nerve disorders undergoing ICD-coded eyelid reconstruction represented a medically complex cohort with substantial hospital utilization and frequent coded complications.