Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Doctor Office Center Suite 6100, 90 Bergen Street, Newark, NJ, USA.
Graefes Arch Clin Exp Ophthalmol. 2023 Jul;261(7):2081-2088. doi: 10.1007/s00417-023-05983-9. Epub 2023 Feb 8.
This study aims to investigate trends and risk factors associated with work-related ocular injuries occurring in adults aged 19-64 using the National Trauma Databank (NTDB).
In this retrospective, cross-sectional study, the NTDB was used to collect all patients with an ICD-9 code of work-related ocular trauma from 2007 to 2014. Demographic data and risk factors collected included age, gender, race, setting, machinery, and mechanism. Descriptive statistics, univariate, and logistic regression multivariate analyses were conducted.
Between 2007 and 2014, 234,983 cases of work-related trauma were identified, of which 11,097 (5.7%) cases involved ocular trauma. The mean age of patients was 40.7 years (SD = 12.2), and the majority of patients (93.7%) were male. Most injuries occurred in an industrial facility, and the most common injuries were orbital floor fractures (OFFs), ocular contusions, open wounds to the adnexa, and open globe injuries (OGIs). OFFs most commonly involved a concurrent fracture of another facial or skull bone. Male gender (RR = 1.22; CI 1.09-1.38), accidental falls (RR = 1.50; CI 1.41-1.60), trauma from falling objects (RR = 1.34; CI 1.21-1.48), involvement in an unarmed fight (RR = 1.63; CI 1.39-1.91), assault by a blunt object (RR = 1.59; CI 1.31-1.91), and injury caused by animals (RR = 1.63; CI 1.30-2.02) were risk factors for OFFs. Patients with OFFs were less likely to have a concurrent OGI (RR = 0.27; CI 0.23-0.32). On the other hand, injuries occurring in industrial facilities (RR = 1.29; CI 1.11-1.51) and injuries with a loose foreign body striking the eye or adnexa (RR = 1.54; CI 1.28-1.84) were risk factors for OGI. The most common causes of work-related ocular trauma were accidental falls, motor vehicle accidents, and accidentally being struck in the eye. The mean length of hospital stay was 6.56 days (SD = 10.82); 36.7% of patients required ICU admission, and the overall in-hospital mortality rate was 2.8%.
The majority of work-related ocular trauma occurred in men, most commonly in industrial locations. Accidental falls were the most common identified cause of trauma. OFF was the most common ocular injury; 80% of OFF cases involved additional facial and skull fractures. Patients with OFFs were less likely to have a concurrent OGI compared with patients without OFFs.
本研究旨在使用国家创伤数据库（NTDB）调查 19-64 岁成年人职业性眼部损伤的趋势和相关风险因素。
在这项回顾性、横断面研究中，使用 NTDB 收集了 2007 年至 2014 年所有职业性眼部创伤 ICD-9 编码的患者。收集的人口统计学数据和风险因素包括年龄、性别、种族、地点、机械和机制。进行了描述性统计、单变量和逻辑回归多变量分析。
在 2007 年至 2014 年期间，确定了 234983 例职业性创伤病例，其中 11097 例（5.7%）涉及眼部创伤。患者的平均年龄为 40.7 岁（SD=12.2），大多数患者（93.7%）为男性。大多数损伤发生在工业设施，最常见的损伤是眶底骨折（OFF）、眼部挫伤、眼眶附件开放性创伤和开放性眼球损伤（OGI）。OFF 最常伴有其他面部或颅骨骨折。男性（RR=1.22；95%CI 1.09-1.38）、意外跌倒（RR=1.50；95%CI 1.41-1.60）、坠落物致伤（RR=1.34；95%CI 1.21-1.48）、非武装斗殴（RR=1.63；95%CI 1.39-1.91）、钝器致伤（RR=1.59；95%CI 1.31-1.91）和动物致伤（RR=1.63；95%CI 1.30-2.02）是 OFF 的风险因素。发生 OFF 的患者更不可能同时发生 OGI（RR=0.27；95%CI 0.23-0.32）。另一方面，在工业设施中发生的损伤（RR=1.29；95%CI 1.11-1.51）和有松动的异物撞击眼睛或眼眶附件（RR=1.54；95%CI 1.28-1.84）是 OGI 的风险因素。职业性眼部创伤最常见的原因是意外跌倒、机动车事故和意外眼部撞击。平均住院时间为 6.56 天（SD=10.82）；36.7%的患者需要入住 ICU，总住院死亡率为 2.8%。
大多数职业性眼部创伤发生在男性，最常见于工业场所。意外跌倒是最常见的创伤原因。OFF 是最常见的眼部损伤；80%的 OFF 病例伴有其他面部和颅骨骨折。与未发生 OFF 的患者相比，发生 OFF 的患者更不可能同时发生 OGI。
