Risk factors of orbital complications in outpatients presenting with severe rhinosinusitis: A case‐control study

Objectives We assessed associations of potential factors with orbital complications in acute rhinosinusitis (ARS) patients. Design An unmatched case‐control study. Setting A tertiary referral hospital in Thailand. Participants Consecutive outpatients of any age with severe ARS (visual analog scale ≥ 7) with and without orbital complications. Main outcome measures Patients were enrolled from January 2013 to December 2018. Forty‐three ARS patients (55.8% female, median age 45.6, (range 2.0‐93.0) years) were included, with 19 patients in the complicated group and 24 in the uncomplicated group. Patient characteristics (gender, age, diabetes, immune status), symptoms and signs, site of infection and type of pathogenic bacteria were recorded and assessed their associations with orbital complications by univariable and multivariable logistic regression analyses. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results The most common orbital complication was subperiosteal abscess (42.1%), followed by orbital cellulitis (15.8%) and cavernous sinus thrombosis (10.5%). Multivariable logistic regression analysis demonstrated a positive association with orbital complications (pseudo R2 0.4) for ethmoid sinusitis (OR 31.1, 95% CI [2.3‐430.6]) and a short duration of symptoms (OR 0.9, 95% CI [0.8‐0.9]). Conclusions Orbital complications were associated with ethmoid sinusitis with a short duration of ARS symptoms.