The theatrical exhibition industry made huge strides in its recovery throughout 2021, culminating in an exceptional fourth quarter, during which North American box office crossed the $2 billion mark for the first time since the onset of the pandemic.
3 for the industry, Spider-Man has now become our No.
1 highest-grossing film of all time, driven by our sustained outperformance on this title.
Over 48 million guests visited our global Cinemark theaters in the fourth quarter, and that consumer enthusiasm translated into strong results.
On a worldwide basis, our fourth quarter attendance grew 57% compared to 3Q '21.
Once again, Cinemark surpassed North American industry box office recovery this past quarter, over-indexing by more than 700 basis points when comparing 4Q '21 box office results against 4Q '19.
Adjusted EBITDA in the fourth quarter was positive $140 million, and that sizable 4Q result drove positive adjusted EBITDA of $80 million for the full year.
We have provided examples of the meaningful impact these actions have had throughout the pandemic during prior calls, and their benefits clearly continued in the fourth quarter, as demonstrated by our sustained market share advances compared to 2019, guest satisfaction scores averaging 90%, and as I mentioned a moment ago, positive adjusted EBITDA and cash flow.
with regard to moviegoing, as well as consumer sentiment, which has improved to 75% of moviegoers, indicating they are comfortable returning to theaters today and over 80% within the next month.
We are now directly connected to more than 20 million addressable guests across our global circuit.
During the fourth quarter, we added 40,000 new Movie Club members, bringing our membership base to within 1% of its pre-pandemic level at approximately 940,000 members.
We continue to receive tremendous feedback about our unique transaction-based subscription program that allows members to roll over unused monthly credits, share credits with friends and family, and receive a meaningful 20% discount on concessions.
By the end of the year, more than 100,000 members achieved this heightened status, which they will enjoy throughout the entirety of 2022.
Examples include our Luxury Lounger recliner seats in over 65% of our U.S. footprint, nearly 300 premium large-format XD and IMAX auditoriums worldwide, immersive D-BOX motion seating across 250 of our theaters, the best sight and sound technology in the industry, and enhanced food and beverage offerings throughout 75% of our global circuit.
Our worldwide attendance was 48.1 million patrons for the fourth quarter.
We delivered $666.7 million of total revenue, $139.4 million of adjusted EBITDA, and $208 million of operating cash flow.
Notably, these worldwide results were driven by robust performance in both our domestic and international segments, with each segment generating positive adjusted EBITDA in the quarter and reporting adjusted EBITDA margins in excess of 20%.
Taking a closer look at our U.S. operations in the fourth quarter, our attendance rebounded to 31.2 million patrons, representing a 45% increase over the third quarter and underscoring the recovery of theatrical moviegoing.
We were able to service these guests with operating hours that were essentially flat to last quarter and approximately 20% below that of pre-COVID, which speaks volumes to the operational efficiencies and technological advances we've achieved since the onset of the pandemic.
Our domestic admissions revenue rebounded to $287.3 million in the fourth quarter on an average ticket price of $9.21.
This is 400 basis points higher compared with the fourth quarter of 2019.
concessions revenue was $207.8 million in the fourth quarter and reached 90% of fourth quarter 2019 levels, with an all-time high per cap of $6.66.
Our food and beverage per cap remained above $6 throughout 2021 due to a few factors, including heightened indulgence in food and beverage consumption, particularly within our core concession categories; a mix of moviegoers that tends to skew higher in-purchase incidents; and our operating hours, which, while reduced, remain concentrated in time frames that are more conducive to concession purchases.
Domestic other revenue also benefited from the uptick in attendance and increased more than 50% quarter over quarter to $56.6 million, driven by volume-related increases in screen ads and transaction fees.
Altogether, fourth quarter total domestic revenue was $551.7 million, with positive adjusted EBITDA of $115.9 million and an adjusted EBITDA margin of 21%.
We were able to grow our attendance 84% quarter over quarter to 16.9 million patrons, given a lineup of films that resonated extremely well with the Latin demographics, including Encanto, which is a story based in Colombia; Venom: Let There Be Carnage; Eternals; and of course, the global phenomenon, Spider-Man: No Way Home.
We delivered $115 million of total international revenue in the fourth quarter, including $57.6 million of admissions revenue, $40.4 million in concessions revenue, and $17 million of other revenue.
International adjusted EBITDA was $23.5 million for the fourth quarter, with an adjusted EBITDA margin of 20.4%.
Film rental and advertising expense was 57.5% of admissions revenue, driven primarily by a higher concentration of larger, more successful new film releases with an exclusive theatrical window.
Concession costs were 17.6% of concession revenue and were up 40 basis points from last quarter.
Fourth quarter global salaries and wages were $83.7 million and increased 24% quarter over quarter as we hired incremental employees to service the expected surge in attendance.
Facility lease expense was $79.2 million and increased 15.1% quarter over quarter.
Worldwide utilities and other expense was $90.8 million and increased 11% quarter over quarter, driven by variable costs, such as credit card fees that grew in line with volumes and higher utility expenses due to expanded operating hours, particularly for our international segment.
Finally, G&A for the quarter was $49.3 million and increased 27.7% quarter over quarter due to investments in cloud-based software and higher consulting costs, legal fees, and stock-based compensation.
Capital expenditures during the quarter were $38.3 million, including $13.9 million for new build projects that had been committed to prior to the pandemic, and $24.4 million for investments to maintain or enhance our existing theaters, such as laser projectors.
And rounding out our fourth quarter results, we generated net income attributable to Cinemark Holdings, Inc. of $5.7 million, resulting in earnings per share of $0.05, another metric that was positive for the first time since the pandemic and represents another milestone in our recovery during the quarter.
Turning to our expectations around capital expenditures, while still well below our pre-pandemic ranges, we are beginning to ramp up our investments in our theaters in 2022 and expect to spend approximately $125 million on capital expenditures.

Summary:
We delivered $666.7 million of total revenue, $139.4 million of adjusted EBITDA, and $208 million of operating cash flow.
And rounding out our fourth quarter results, we generated net income attributable to Cinemark Holdings, Inc. of $5.7 million, resulting in earnings per share of $0.05, another metric that was positive for the first time since the pandemic and represents another milestone in our recovery during the quarter.