[Analysis of risk factors influencing the effectiveness of conservative treatment for orbital complications of acute sinusitis].

Abstract

Objective: To identify the risk factors affecting the effectiveness of conservative treatment for acute sinusitis with orbital complications and provide evidence for recognition of high-risk patients. Methods: A retrospective analysis was conducted on 86 patients with acute sinusitis and orbital complications treated at Qingdao University Affiliated Hospital from 2017 to 2024 (61 males, 25 females; median age: 6.5 years). Patients were divided into an ineffective conservative treatment group and an effective conservative treatment group based on the outcomes after 48-72 hours of conservative treatment. Clinical characteristics were collected, and variables were screened using Lasso regression. Multivariate logistic regression was used to analyze the risk factors for poor conservative treatment outcomes, and a nomogram model was constructed to validate its predictive performance. Results: The overall success rate of conservative treatment was 50% (43/86). Multivariate logistic analysis showed that type Ⅲ orbital complications (OR=0.17, P=0.017) and the presence of bone destruction (OR=0.29, P=0.046) were independent risk factors for poor conservative treatment outcomes. The area under the ROC curve (AUC) of the combined predictive model was 0.762, with a sensitivity of 76.7% and a specificity of 69.8%. Conclusion: Patients with acute sinusitis and orbital complications, especially those with subperiosteal abscesses (type Ⅲ) and concurrent bone destruction, have a lower effectiveness rate of conservative treatment. These patients should be closely monitored for clinical signs and considered for prompt surgical intervention when necessary.