Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Invest Ophthalmol Vis Sci. 2018 May 1;59(6):2487-2494. doi: 10.1167/iovs.18-23783.
Endophthalmitis describes any intraocular inflammation that involves both the posterior and anterior segments and is divided into endogenous and exogenous types according to its pathogenesis. The incidence of endophthalmitis and its risk factors have been extensively evaluated. However, few studies have explored the mortality rate in patients diagnosed with endophthalmitis.
We obtained data entered into the National Health Insurance Research Database (NHIRD) from 2000 to 2013. The data collected included all discharge diagnoses of endophthalmitis in inpatients. Baseline characteristics, comorbidities, and prognostic factors were evaluated.
This study identified 7764 patients who were diagnosed with endophthalmitis in Taiwan from 2000 to 2013. The mortality rate was 0.97% (75/7764), and the mean age was 63.57 ± 15.72 years. Epidemiological characteristics were compared as "with or without" for different systemic comorbidities, and the results indicated that the adjusted odds ratio (AOR) was significantly higher in cases comorbid with renal disease (AOR 2.864, P = 0.001), septicemia (AOR 8.886, P < 0.001), pneumonia (AOR 2.072, P = 0.030), and tumors (AOR 7.437, P < 0.001). However, comorbidity with diabetes mellitus (DM) lowered the AOR by 0.500-fold (P = 0.026). There was no significant difference in ORs between patients comorbid with hypertension, depression, anxiety, hyperlipidemia, thyrotoxicosis, liver disease, or injury (all P > 0.05).
Among inpatients with endophthalmitis, predictors of mortality include renal disease, septicemia, pneumonia, neoplasia, a greater burden of comorbidity (especially catastrophic illness), longer hospital stays (more than 11 days), and higher medical costs. Interestingly, DM decreased the OR for inpatient mortality.
眼内炎是一种累及眼后段和前段的眼内炎症，根据其发病机制可分为内源性和外源性。眼内炎的发病率及其危险因素已得到广泛评估。然而，很少有研究探讨诊断为眼内炎的患者的死亡率。
我们从 2000 年至 2013 年从国家健康保险研究数据库（NHIRD）中获取数据。收集的数据包括住院患者眼内炎的所有出院诊断。评估了基线特征、合并症和预后因素。
本研究在台湾从 2000 年至 2013 年期间共确定了 7764 例诊断为眼内炎的患者。死亡率为 0.97%（75/7764），平均年龄为 63.57±15.72 岁。对不同全身合并症的“有或无”进行了流行病学特征比较，结果表明，合并肾脏病（优势比[OR]2.864，P=0.001）、败血症（OR 8.886，P<0.001）、肺炎（OR 2.072，P=0.030）和肿瘤（OR 7.437，P<0.001）的患者的调整后 OR（AOR）显著更高。然而，合并糖尿病（DM）使 AOR 降低了 0.500 倍（P=0.026）。合并高血压、抑郁、焦虑、高脂血症、甲状腺功能亢进症、肝病或损伤的患者的 OR 无显著差异（均 P>0.05）。
在患有眼内炎的住院患者中，死亡率的预测因素包括肾脏病、败血症、肺炎、肿瘤、合并症负担增加（特别是灾难性疾病）、住院时间延长（超过 11 天）和医疗费用增加。有趣的是，DM 降低了住院患者死亡率的 OR。
