Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA.
Department of Anesthesia and Pain Management, University of Texas, Southwestern Medical Center, Dallas, Texas, USA.
Ophthalmic Epidemiol. 2024 Apr;31(2):169-177. doi: 10.1080/09286586.2023.2222792. Epub 2023 Jun 22.
To investigate domestic violence (DV)-related ocular injuries among adult emergency department (ED) patients in the US.
This was a retrospective, cross-sectional study of patients with a diagnosis of DV and diagnosis of ocular injury in the Nationwide Emergency Department Sample (NEDS) from 2008-2017. We identified patient- and hospital-level variables associated with DV-related ocular injuries. We calculated annual incidence rates using US Census data. Adjusting for inflation using the Consumer Price Index, we calculated mean and total charges.
From 2008-2017, there were 26,215 ED visits for ocular injuries related to DV with an average incidence of 1.09 per 100,000 adult population (female patients, 84.5%; mean age [SE], 34.3 [0.2]). DV-related ocular injuries were most prevalent among patients in the lowest income quartile (39.1%) and on Medicaid (37.4%). Most ED visits presented to metropolitan teaching (55.4%), non-trauma (46.7%), and south regional (30.5%) hospitals. The most common ocular injury was contusion of eye/adnexa (61.1%). The hospital admission rate was 5.2% with a mean hospital stay of 2.9 [0.2]. The inflation-adjusted mean cost for medical services was $38,540 [2,310.8] per encounter with an average increase of $2,116 per encounter, annually. The likelihood of hospital admission increased for patients aged ≥60 years old, on Medicare, and with open globes or facial/orbital fractures (all < .05).
Contusion of the eye/adnexa was the most common ocular injury among patients with DV-related ED visits. To better facilitate referrals to social services, ophthalmologists should utilize DV screenings, especially towards women and patients of less privileged socioeconomic status.
调查美国成人急诊部（ED）患者中与家庭暴力（DV）相关的眼部损伤。
这是一项回顾性、横断面研究，研究对象为 2008 年至 2017 年全美急诊部抽样调查（NEDS）中诊断为 DV 和眼部损伤的患者。我们确定了与 DV 相关眼部损伤相关的患者和医院水平变量。我们使用美国人口普查数据计算了每年的发病率。使用消费者价格指数（CPI）对通货膨胀进行调整后，我们计算了平均和总费用。
2008 年至 2017 年，共有 26215 例因与 DV 相关的眼部损伤而就诊于 ED，成人人群中的平均发病率为每 10 万人 1.09 例（女性患者占 84.5%；平均年龄[SE]为 34.3[0.2]）。在收入最低的四分位数（39.1%）和医疗补助（37.4%）的患者中，DV 相关眼部损伤最为常见。大多数 ED 就诊于大都市教学（55.4%）、非创伤（46.7%）和南部地区（30.5%）医院。最常见的眼部损伤是眼球/附属器挫伤（61.1%）。住院率为 5.2%，平均住院时间为 2.9[0.2]。经通胀调整后的每次就诊医疗服务平均费用为 38540 美元[2310.8]，每年平均增加 2116 美元。对于年龄≥60 岁、参加医疗保险和开放性眼球或面部/眼眶骨折的患者，住院的可能性增加（均<0.05）。
在因 DV 就诊于 ED 的患者中，眼球/附属器挫伤是最常见的眼部损伤。为了更好地促进向社会服务的转介，眼科医生应利用 DV 筛查，尤其是针对女性和社会经济地位较低的患者。
