Department of Surgery, Division of Ophthalmology, McMaster University, 1200 Main Street West, 3V2, L8N 3Z5, Hamilton, ON, Canada.
Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, Canada.
BMC Ophthalmol. 2023 Jul 10;23(1):305. doi: 10.1186/s12886-023-02999-x.
Understanding the epidemiology of ophthalmic presentations to emergency departments can help guide resource allocation, medical education programs, and optimize the patient experience. The purpose of this investigation was to summarize and assess the urgency of ophthalmic presentations in emergency departments (EDs) in Ontario, Canada over a 5-year period.
This was a multicentered retrospective review of all patient presentations to EDs in Ontario between January 1st, 2012, to December 31st, 2017. Presentations were included if patients had an ophthalmic related ICD-10 code as their primary problem prompting ED presentation.
A total of 774,057 patients patient presentations were included across the pediatric (149,679 patients) and adult (624,378 patients) cohorts. The mean (SD) age at presentation was 47.4 (17.9) years, and 6.54 (5.20) in the adult and pediatric cohorts respectively. Of the total presentations, 256,776 (33.1%) were due to a trauma related presentation. Problems pertaining to Cornea and External disease were the most common reason for presentation (51.0% of cases). Of all presentations, 34.1% were classified as either 'emergent' or 'likely emergent'; the remaining presentations were either 'non-emergent' (39.5%) or the urgency 'could not be determined' (26.4%). The three most frequent presentations were due to conjunctivitis (121,175 cases or 15.7%), ocular foreign bodies (104,322 cases or 13.5%), and corneal / conjunctival abrasions (94,554 cases of 12.2%).
This investigation summarizes all ophthalmic presentations to EDs in Ontario, Canada over a 5-year period. The results of this investigation can help guide ophthalmic related knowledge translation. Additionally, these results highlight that in Canadian EDs, a significant proportion of ophthalmic presentations are nonurgent; systems level efforts to improve access for eye-related complaints to healthcare professionals outside of the ED can help facilitate improved resource allocation. As we emerge from the COVID-19 pandemic, optimising the structure of patient care access is crucial to help alleviate the pressure from overburdened EDs while effectively meeting patient healthcare needs.
了解眼科急症在急诊部的流行病学可以帮助指导资源分配、医学教育计划，并优化患者体验。本研究的目的是总结和评估在加拿大安大略省的急诊部（ED）中眼科急症的紧急程度，时间跨度为 5 年。
这是一项对 2012 年 1 月 1 日至 2017 年 12 月 31 日期间安大略省所有 ED 就诊患者的多中心回顾性研究。如果患者的主要就诊问题是与眼科相关的 ICD-10 编码，则将其纳入研究。
在儿科（149679 例）和成人（624378 例）队列中，共有 774057 例患者就诊。就诊时的平均（SD）年龄分别为 47.4（17.9）岁和 47.4（17.9）岁。在所有就诊中，256776 例（33.1%）是由于外伤引起的。角膜和外眼病是最常见的就诊原因（占病例的 51.0%）。在所有就诊中，34.1%被归类为“紧急”或“可能紧急”；其余的就诊要么是“非紧急”（39.5%），要么是“紧急程度无法确定”（26.4%）。最常见的三种就诊是结膜炎（121175 例，占 15.7%）、眼内异物（104322 例，占 13.5%）和角膜/结膜擦伤（94554 例，占 12.2%）。
本研究总结了加拿大安大略省 5 年来所有在急诊部就诊的眼科病例。该研究的结果可以帮助指导与眼科相关的知识转化。此外，这些结果表明，在加拿大 ED 中，相当一部分眼科就诊是非紧急的；在 ED 之外，为眼部相关投诉提供医疗保健专业人员的机会的系统层面的努力可以帮助改善资源分配。随着我们走出 COVID-19 大流行，优化患者护理通道的结构对于缓解 ED 负担过重的压力和有效满足患者的医疗保健需求至关重要。
