Bigoteau M, Massot M, Baudet J-M, Pasco J, Pichard T, Slim M, Bourges J-L, Pisella P-J, Khanna R K
Service d'ophtalmologie, Centre hospitalier universitaire régional de Bretonneau, Tours, France; Service d'ophtalmologie, Centre hospitalier Jacques-Cœur, Bourges, France.
Département d'information médicale, Centre hospitalier Jacques-Cœur, Bourges, France.
J Fr Ophtalmol. 2021 Jun;44(6):813-821. doi: 10.1016/j.jfo.2020.08.036. Epub 2021 May 5.
This study aimed to analyse the epidemiological characteristics of ophthalmological emergencies at the Bourges Medical Center (CHB) and to identify factors associated with severity according to the Base Score in a region of France considered a healthcare desert.
All consecutive charts of patients seen for an eye-related condition between January 1 and April 30, 2019 in the ocular emergency department of the CHB were studied retrospectively. Seven demographic and nine medical variables were collected, and ocular severity was defined according to the Base Score. Linear regressions were performed to identify the factors associated with higher severity.
1809 patients were included (mean age: 53.3±22.7 years, 51.4% women), of whom 1619 (89.5%) were self-referred. Ocular surface disease (12.5%) was the most frequent diagnosis. The severity of the eye-related condition was significantly associated with the following factors: male gender, distance from home to the emergency department, presentation soon after the onset of symptoms, and referral from a physician (ophthalmologist or not). The regression coefficient was greater than 1 only for the patient referral pattern.
The current study highlights that when patients with ocular emergencies can self-refer to an ocular emergency department within a French healthcare desert, 9 patients out of 10 self-refer. Referral from a physician is the main factor associated with ocular severity; thus, these cases should be considered severe until proven otherwise.
本研究旨在分析布尔日医疗中心(CHB)眼科急诊的流行病学特征,并根据基础评分确定在法国一个被视为医疗服务荒漠地区与严重程度相关的因素。
对2019年1月1日至4月30日期间在CHB眼科急诊科就诊的所有连续性眼病患者病历进行回顾性研究。收集了7个人口统计学变量和9个医学变量,并根据基础评分定义眼部严重程度。进行线性回归以确定与更高严重程度相关的因素。
纳入1809例患者(平均年龄:53.3±22.7岁,51.4%为女性),其中1619例(89.5%)为自行前来就诊。眼表疾病(12.5%)是最常见的诊断。眼部疾病的严重程度与以下因素显著相关:男性、家到急诊科的距离、症状发作后不久就诊以及医生转诊(无论是否为眼科医生)。仅患者转诊模式的回归系数大于1。
当前研究强调,在法国医疗服务荒漠地区,眼部急诊患者中十分之九会自行前往眼科急诊科就诊。医生转诊是与眼部严重程度相关的主要因素;因此,在未得到其他证明之前,这些病例应被视为严重病例。