Harvard Medical School, Boston, Massachusetts, USA.
Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA.
Am J Ophthalmol. 2021 Sep;229:82-89. doi: 10.1016/j.ajo.2021.03.063. Epub 2021 Apr 20.
To identify common causes of emergency department-treated eye injury among older adults in the United States and to characterize fall-related ocular trauma in this population.
Retrospective cohort study.
Data from the National Electronic Injury Surveillance System, a nationally representative database of US emergency department-treated injuries, was used to assemble a cohort of adults ≥65 years of age with eye injuries between January 1, 2000 and December 31, 2019. Demographic information, diagnosis, disposition, injury location, and the consumer product associated with injury were collected. Narrative descriptions of all injuries were reviewed to identify eye injuries caused by falls.
Four thousand nine hundred fifty-three eye injuries among older adults were reported from 2000-2019, a stratified probability sample representing approximately 238,162 injuries, with an average annual frequency of 12,000 injuries. Falls accounted for 11.5% of these injuries. Fall-related eye injuries commonly presented from home (66.5%) and were more likely to occur in the winter than eye injuries from other causes (28.1% vs 18.4%, P < .01). Risk factors for fall-related eye injury included older age (odds ratio [OR] 1.11 [95% confidence interval {CI} 1.10-1.13 per year), female sex (OR 2.3 [95% CI 1.6-3.1] vs male), black race (OR 2.4 [95% CI 1.3-4.5] vs white), and presentation from a nursing home (OR 12.7 [95% CI 4.9-32.8] vs other locations). Older adults with fall-related injuries were more likely to be hospitalized (OR 22.8 [95% CI 15.3-33.9]) and to have a ruptured globe (OR 14.1 [95% CI 6.5-30.6]) than those with fall-unrelated injury.
Falls are an important mechanism of ocular trauma in older adults and are associated with worse outcomes compared with eye injuries from other causes.
确定美国老年急诊治疗眼部损伤的常见原因，并描述该人群中与跌倒相关的眼部创伤。
回顾性队列研究。
利用美国国家电子伤害监测系统的数据，该系统是一个具有全国代表性的急诊治疗伤害数据库，收集了 2000 年 1 月 1 日至 2019 年 12 月 31 日期间年龄≥65 岁的眼部受伤成年人队列。收集人口统计学信息、诊断、处理、受伤部位和与受伤相关的消费品。对所有伤害的描述性文字进行审查，以确定由跌倒引起的眼部伤害。
2000-2019 年报告了 4953 例老年人眼部损伤，这是一个分层概率样本，代表了大约 238162 例损伤，平均每年发生 12000 例损伤。跌倒占这些损伤的 11.5%。与跌倒相关的眼部损伤常见于家庭（66.5%），并且比其他原因引起的眼部损伤更可能发生在冬季（28.1%比 18.4%，P<0.01）。与跌倒相关的眼部损伤的危险因素包括年龄较大（每增加 1 年，比值比[OR]为 1.11[95%置信区间{CI}为 1.10-1.13]）、女性（OR 2.3[95%CI 1.6-3.1]比男性）、黑人（OR 2.4[95%CI 1.3-4.5]比白人）和从疗养院就诊（OR 12.7[95%CI 4.9-32.8]比其他地点）。与跌倒无关的眼部损伤相比，与跌倒相关的眼部损伤的老年人更有可能住院（OR 22.8[95%CI 15.3-33.9]）和发生眼球破裂（OR 14.1[95%CI 6.5-30.6]）。
跌倒是老年人眼部创伤的一个重要机制，与其他原因引起的眼部损伤相比，其后果更严重。
