Brophy Megan, Sinclair Sara A, Hostetler Sarah Grim, Xiang Huiyun
Center for Injury Research and Policy, Children's Research Institute, Columbus Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
Pediatrics. 2006 Jun;117(6):e1263-71. doi: 10.1542/peds.2005-1950.
An estimated 2.4 million eye injuries occur in the United States each year, with nearly 35% of injuries among persons aged 17 years or less. Although previous research has identified some of the characteristics of pediatric eye injuries, many studies focused only on a specific patient population or type of eye injury or relied on self-reported data. In addition, little information has been reported on the total charges associated with treating pediatric eye injuries. Using a large national database, our aim was to examine hospitalizations for the treatment of pediatric eye injuries in the United States, including the demographic, medical care, and financial characteristics associated with major categories of eye injury.
Cross-sectional data were derived from the 2000 Kids' Inpatient Database of the Healthcare Cost and Utilization Project. Eye injury-related hospitalizations were identified by using International Classification of Disease, Ninth Revision, Clinical Modification codes. Discharges were selected if the eye injury was the principal or secondary diagnosis. Guidelines from the Centers for Disease Control and Prevention were used to group external-cause-of-injury codes into broader categories to allow meaningful comparison with previous studies. The reported charges for the treatment of eye injuries and the expected primary payer were determined. Cases were statistically weighted to produce national estimates of hospitalizations for pediatric eye injuries and to determine the characteristics of these injuries.
Data were collected by the Kids' Inpatient Database for 3834 actual eye injury-related hospitalizations. These records represent an estimated 7527 eye injury-related hospitalizations among children aged 20 years or less in the United States during 2000. Inpatient charges for the treatment of these injuries were more than $88 million. The rate of hospitalization for pediatric eye injuries in the United States in 2000 was 8.9 per 100,000 persons aged 20 years or less. Young adults aged 18 to 20 years accounted for the highest percentage of hospitalizations (23.7%). Males accounted for 69.7% of hospitalizations. A majority of hospitalizations were for open wounds of the ocular adnexa. Motor vehicle crash was the most common cause of injury, followed by being struck by or against an object and being cut or pierced.
These findings illustrate the considerable morbidity, financial burden, and proximal causes for pediatric eye injury-related hospitalizations. Our data support the need for eye injury prevention efforts that consider the age, gender, and developmental stage of children. Educating parents and children about the potential for eye injuries at home and during hazardous activities is an important public health goal. In addition, promoting the use of appropriate protective eyewear by children during activities with a high risk of ocular trauma will help prevent future eye injuries.
在美国,每年估计有240万起眼部受伤事件,其中近35%的受伤者年龄在17岁及以下。尽管先前的研究已经确定了小儿眼部受伤的一些特征,但许多研究仅关注特定的患者群体或眼部受伤类型,或者依赖自我报告的数据。此外,关于治疗小儿眼部受伤的总费用的信息报道较少。利用一个大型的全国性数据库,我们的目的是研究美国小儿眼部受伤治疗的住院情况,包括与主要眼部受伤类别相关的人口统计学、医疗护理和财务特征。
横断面数据来自医疗成本和利用项目2000年的儿童住院数据库。通过使用国际疾病分类第九版临床修订本代码来识别与眼部受伤相关的住院情况。如果眼部受伤是主要或次要诊断,则选择出院病例。疾病控制和预防中心的指南被用于将伤害外部原因代码分组为更广泛的类别,以便与先前的研究进行有意义的比较。确定了报告的眼部受伤治疗费用和预期的主要支付方。对病例进行统计加权,以得出美国小儿眼部受伤住院情况的全国估计数,并确定这些受伤情况的特征。
儿童住院数据库收集了3834例实际与眼部受伤相关的住院数据。这些记录代表了2000年美国20岁及以下儿童中估计7527例与眼部受伤相关的住院情况。这些受伤治疗的住院费用超过8800万美元。2000年美国小儿眼部受伤的住院率为每10万名20岁及以下的人中有8.9例。18至20岁的年轻人占住院人数的比例最高(23.7%)。男性占住院人数的69.7%。大多数住院是因为眼附属器开放性伤口。机动车碰撞是最常见的受伤原因,其次是被物体撞击或碰撞以及被切割或刺穿。
这些发现说明了小儿眼部受伤相关住院情况的相当高的发病率、财务负担和近端原因。我们的数据支持需要开展眼部受伤预防工作,考虑儿童的年龄、性别和发育阶段。教育家长和儿童关于在家中和危险活动期间眼部受伤的可能性是一个重要的公共卫生目标。此外,促进儿童在眼部创伤风险高的活动中使用适当的防护眼镜将有助于预防未来的眼部受伤。