Haring R Sterling, Canner Joseph K, Haider Adil H, Schneider Eric B
Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States.
Injury. 2016 Jan;47(1):104-8. doi: 10.1016/j.injury.2015.07.020. Epub 2015 Jul 23.
Ocular complaints represent a sizeable burden to emergency departments, accounting for an estimated 2.4 million ED visits annually. We sought to characterise visits associated with ocular injury and examine factors contributing to inpatient admission.
We searched the Nationwide Emergency Department Sample between 2006 and 2011 and identified cases in which patients presented with a primary or secondary diagnosis of ocular trauma. We described these cases according to age, sex, external mechanism of injury, payer status, and identified relationships between these variables. Logistic regression models were employed to identify crude and adjusted relative odds of admission to inpatient status based on patient demographics, mechanism of injury, payer status, and the existence of multiple injuries.
Between 2006 and 2011, a total of 5541,434 visits were made to EDs in the United States with a primary or other diagnosis of ocular trauma; ocular trauma was the primary diagnosis in 77.9% of these cases. Overall, mean age at presentation was 33.8 years and the majority of patients were male (64.8%). Male sex, older age, being struck by or against an object, the existence of multiple injuries, and Medicaid as a primary payer were all associated with significantly higher odds of hospital admission.
The distribution of primary external mechanism of injury suggested that individuals are at higher risks for different injury types at each successive stage of life. Age and injury mechanism were correlated with odds of admission to inpatient status, with the highest odds among older adults who had been injured by being struck by or against an object.
Ocular injury plays a substantial role in the ED. Further work is necessary to determine whether developing and implementing age- and sex-appropriate prevention strategies could reduce the incidence of ocular injury and reduce morbidity related to these types of injuries.
眼部疾病给急诊科带来了相当大的负担,估计每年有240万次急诊就诊。我们试图描述与眼外伤相关的就诊情况,并研究导致住院的因素。
我们检索了2006年至2011年的全国急诊科样本,确定了患者以眼外伤为主诊断或次要诊断就诊的病例。我们根据年龄、性别、外部损伤机制、支付者状态对这些病例进行了描述,并确定了这些变量之间的关系。采用逻辑回归模型,根据患者人口统计学、损伤机制、支付者状态以及多处损伤的存在情况,确定住院的粗略和调整后的相对几率。
2006年至2011年期间,美国急诊科共有5541434次就诊,主要诊断或其他诊断为眼外伤;其中77.9%的病例眼外伤为主要诊断。总体而言,就诊时的平均年龄为33.8岁,大多数患者为男性(64.8%)。男性、年龄较大、被物体撞击或碰撞、多处受伤以及以医疗补助作为主要支付者,均与住院几率显著较高相关。
主要外部损伤机制的分布表明,在生命的每个连续阶段,个体面临不同损伤类型的风险更高。年龄和损伤机制与住院几率相关,被物体撞击或碰撞受伤的老年人住院几率最高。
眼外伤在急诊科中起着重要作用。有必要进一步开展工作,以确定制定和实施适合年龄和性别的预防策略是否可以降低眼外伤的发生率,并降低与这些类型损伤相关的发病率。