Albert Einstein College of Medicine, Bronx, NY, USA.
Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA.
Arq Bras Oftalmol. 2022 May-Jun;85(3):240-248. doi: 10.5935/0004-2749.20220035.
We aimed to study the characteristics of ocular trauma, an important but largely preventable global cause of blindness, in the United States.
Retrospective chart review of the National Trauma Data Bank (2008-2014) was performed. All patients with ocular trauma were identified using ICD-9CM codes. The collected data were statistically analyzed with student's t-test, Chi-squared test, and logistic regression analysis performed using the SPSS software. The significance was set at p<0.05.
It was found that 316,485 (5.93%) of the 5,336,575 admitted trauma patients had ocular injuries. Their mean (SD) age was 41.8 (23) years, and most of them were men (69.4%). Race/ethnicity distribution was White 66.1%, Black 15.1%, and Hispanic 12.3%. The common injuries were orbital 39.5% and eye/adnexa contusions 34%. Associated traumatic brain injury was present in 58.2%. The frequent mechanisms were falls 25.5%, motor vehicle accident-occupant 21.8%, and struck by/against 17.6%. Patients <21 years of age had higher odds of cut/pierce injuries (OR=3.29, 95%CI=3.07-3.51) than the other age groups, those aged 21-64 years had higher odds of motor vehicle accident-cyclist (OR=4.95, 95%CI=4.71-5.19), and those >65 years had higher odds of falls (OR=16.75, 95%CI=16.39-17.12); p<0.001. The Blacks had a greater likelihood of firearm injuries (OR=3.24, 95%CI=3.10-3.39) than the other racial/ethnic groups, the Hispanics experienced more of cut/pierce injuries (OR=2.01, 95%CI=1.85-2.18), and the Whites experienced more of falls (OR=2.3, 95%CI=2.3-2.4); p<0.001. The Blacks (OR=3.41, 95%CI=3.34-3.48) and Hispanics (OR=1.75, 95%CI=1.71-1.79) mostly suffered assaults, while the Whites suffered unintentional injuries (OR=2.78 95%CI=2.74-2.84); p<0.001. Optic nerve/visual pathway injuries had the greatest association with very severe injury severity scores (OR=3.27, 95%CI=3.05-3.49) and severe Glasgow Coma Scores (OR=3.30, 95%CI=3.08-3.54); p<0.001. The mortality rate was 3.9%.
Male preponderance and falls, motor vehicle accident-occupant, and struck by/against mechanisms agree with the previous reports. The identified demographic patterns underscore the need to develop group-specific preventive measures.
我们旨在研究美国眼部创伤的特征，眼部创伤是全球导致失明的一个重要但很大程度上可预防的原因。
对国家创伤数据库（2008-2014 年）进行回顾性图表审查。使用 ICD-9CM 代码识别所有眼部创伤患者。使用 SPSS 软件进行学生 t 检验、卡方检验和逻辑回归分析对收集的数据进行统计学分析。显著性水平设置为 p<0.05。
研究发现，5336575 名接受创伤治疗的患者中有 316485 人（5.93%）患有眼部损伤。他们的平均（SD）年龄为 41.8（23）岁，大多数是男性（69.4%）。种族/民族分布为白人 66.1%，黑人 15.1%，西班牙裔 12.3%。常见的损伤是眼眶 39.5%和眼部/附属器挫伤 34%。58.2%的患者伴有外伤性脑损伤。常见的机制是跌倒 25.5%，机动车事故-乘客 21.8%，被打/碰撞 17.6%。<21 岁的患者发生切割/刺伤的几率更高（OR=3.29，95%CI=3.07-3.51），21-64 岁的患者发生机动车事故-自行车的几率更高（OR=4.95，95%CI=4.71-5.19），>65 岁的患者发生跌倒的几率更高（OR=16.75，95%CI=16.39-17.12）；p<0.001。黑人发生枪伤的可能性（OR=3.24，95%CI=3.10-3.39）大于其他种族/民族群体，西班牙裔发生切割/刺伤的几率更高（OR=2.01，95%CI=1.85-2.18），白人发生跌倒的几率更高（OR=2.3，95%CI=2.3-2.4）；p<0.001。黑人（OR=3.41，95%CI=3.34-3.48）和西班牙裔（OR=1.75，95%CI=1.71-1.79）主要遭受攻击，而白人主要遭受非故意损伤（OR=2.78，95%CI=2.74-2.84）；p<0.001。视神经/视觉通路损伤与严重损伤严重程度评分（OR=3.27，95%CI=3.05-3.49）和严重格拉斯哥昏迷评分（OR=3.30，95%CI=3.08-3.54）的关联性最大；p<0.001。死亡率为 3.9%。
男性居多和跌倒、机动车事故-乘客、被打/碰撞的机制与之前的报告一致。确定的人口统计学模式强调需要制定特定群体的预防措施。
