Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut.
J AAPOS. 2023 Dec;27(6):335.e1-335.e8. doi: 10.1016/j.jaapos.2023.09.008. Epub 2023 Nov 4.
To study the epidemiology of all domestic violence (DV)-related ocular injuries among pediatric emergency department (ED) patients in the United States.
This is a retrospective, cross-sectional study of isolated children (<18 years of age) with a diagnosis of DV and primary or secondary diagnosis of ocular injuries in the Nationwide Emergency Department Sample, 2008-2017. We calculated annual incidence of DV-related ocular injuries and prevalence by demographic variables, including age, sex, and income quartile. Median charges, median length of inpatient hospital stay, and factors associated with hospitalization were also measured.
From 2008 to 2017, there were 4,125 ED encounters, with an average incidence of 0.56 per 100,000 population (males, 50.0%; mean age [SE], 9.2 [0.3]). Patients in the lowest income quartile (42.6%) and with Medicaid insurance (63.2%) were the most prevalent. The most common known perpetrator was a family member (29.4%). Most ED encounters took place at southern regional (28.6%), metropolitan teaching (67.1%) and designated trauma hospitals (57.8%). Contusion of the eye/adnexa and being struck by or against an object were the most common ocular diagnosis and known mechanism of injury, respectively. An estimated 12.4% of patients were admitted with a median hospital stay of 4 (IQR, 2-6). Median charges during the study period were $27,415.10 (IQR, $13,142.70-$54,454.90).
DV-related ocular injuries were most prevalent among patients with a low socioeconomic status. Given the historical underreporting of DV, future studies are warranted to identify more specific social determinants of health that contribute to such presentations.
研究美国儿科急诊部(ED)患者中所有与家庭暴力(DV)相关的眼部损伤的流行病学情况。
这是一项回顾性、横断面研究,研究对象为 2008 年至 2017 年全美急诊部样本中患有 DV 且主要或次要诊断为眼部损伤的孤立儿童(<18 岁)。我们按年龄、性别和收入四分位数等人口统计学变量计算了 DV 相关眼部损伤的年发生率和患病率。还测量了中位数费用、中位数住院天数以及与住院相关的因素。
2008 年至 2017 年,共有 4125 例 ED 就诊,平均发病率为每 100000 人 0.56 例(男性占 50.0%;平均年龄[SE]为 9.2[0.3])。收入最低四分位数(42.6%)和有医疗补助保险(63.2%)的患者最为常见。最常见的已知施害者是家庭成员(29.4%)。大多数 ED 就诊发生在南部地区(28.6%)、大都市教学医院(67.1%)和指定创伤医院(57.8%)。眼部挫伤/附件和被物体撞击或撞击是最常见的眼部诊断和已知的损伤机制。估计有 12.4%的患者住院,平均住院时间为 4 天(IQR,2-6 天)。研究期间的中位数费用为 27415.10 美元(IQR,13142.70-54454.90 美元)。
社会经济地位较低的患者中,与 DV 相关的眼部损伤最为常见。鉴于 DV 的历史上报率较低,未来的研究有必要确定更多特定的健康社会决定因素,这些因素会导致此类就诊。