Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Injury. 2024 Mar;55(3):111209. doi: 10.1016/j.injury.2023.111209. Epub 2023 Nov 17.
To determine the incidence, characteristics, disposition, and economic burden of emergency department (ED) visits for ophthalmic trauma in the United States (US).
Retrospective study.
The Nationwide Emergency Department Sample was used to calculate and characterize ED visits for ophthalmic trauma in the US from 2009 to 2018. Linear regression was used to estimate trends in annual incidence and mean inflation-adjusted ED charges. Logistic regression was used to assess variables associated with inpatient admission.
There were over 7.3 million ED visits for ophthalmic trauma in the US over the 10 years, with an annual incidence of 233 per 100,000 population. Patients were predominantly male (65 %), 21-44 years old (39 %), and from low-income households (56 %). Only 1 % of patients were hospitalized. Older age, male sex, metropolitan teaching hospitals, and trauma centers were associated with significantly higher odds of inpatient admission. The mean inflation-adjusted ED charge per visit more than doubled over the decade ($1,333 to $3,187) with total charges exceeding $14 billion. Superficial injuries (44 %) and eyelid/orbit wounds (20 %) accounted for the majority of visits. Orbital floor fractures (4 %) and open globe injuries (2 %) accounted for a minority of visits but were responsible for most admissions (49 % and 29 %, respectively) and the highest mean ED charge ($7,157 and $6,808, respectively).
Ophthalmic trauma represents an increasingly significant burden to EDs in the US. Preventive efforts should target young males from low socioeconomic backgrounds. Strategies to improve outpatient access and redirect non-urgent injuries may help alleviate costs.
在美国确定眼科外伤急诊就诊的发生率、特征、处置情况和经济负担。
回顾性研究。
利用全国急诊样本，计算并描述了 2009 年至 2018 年美国眼科外伤急诊就诊情况。线性回归用于估计年度发病率和调整后通货膨胀的急诊收费的趋势。逻辑回归用于评估与住院相关的变量。
在 10 年间，美国有超过 730 万次眼科外伤急诊就诊，发病率为每 10 万人 233 例。患者主要为男性（65%）、21-44 岁（39%）和低收入家庭（56%）。只有 1%的患者住院。年龄较大、男性、大都市教学医院和创伤中心与住院的可能性显著增加相关。每例就诊的调整后通货膨胀的急诊收费在这十年中增加了一倍多（从 1333 美元增加到 3187 美元），总费用超过 140 亿美元。浅表损伤（44%）和眼睑/眼眶伤口（20%）占就诊的大多数。眶底骨折（4%）和开放性眼球损伤（2%）占就诊的少数，但占大多数住院治疗（分别为 49%和 29%）和最高平均急诊收费（分别为 7157 美元和 6808 美元）。
眼科外伤对美国急诊就诊的负担越来越大。预防措施应针对社会经济地位较低的年轻男性。改善门诊就诊机会和重新分配非紧急伤害的策略可能有助于降低成本。
