Poret J, Arndt C, Barrucand A, Henry A
Ophthalmology Department, Robert-Debré Reims University Hospital, Reims, France.
Clinical Research Department, Institut Ophtalmologique de l'Ouest, Jules-Verne Clinic, Nantes, France.
J Fr Ophtalmol. 2025 Apr;48(4):104448. doi: 10.1016/j.jfo.2025.104448. Epub 2025 Feb 28.
To describe the profiles and management patterns of frequent visitors to the ophthalmology emergency department in comparison to patients who visit only occasionally.
This study conducted a retrospective analysis spanning a 2.5-year period encompassing all visits to the ophthalmology emergency department. Patients who visited four or more times during this period were identified as frequent users and compared with a control group randomly selected from patients who visited only once. Severity scores associated with diagnoses, ranging from 1 to 5 (Base Score), along with clinical characteristics and patient management strategies, were analyzed using both univariate and multivariate analyses.
Of 18,802 visits, 331 patients (constituting 2.23% of the total) were identified as frequent users during the 2.5-year period, with numbers of visits ranging from 4 to 23. In comparison to the control group, frequent users tended to be approximately 10 years older and presented with more severe diagnoses (Base Score 2.43±1.15 versus 1.89±0.94, P=6.35×10). Their visits were predominantly associated with non-traumatic anterior segment pathologies (56% versus 27%) rather than traumatic pathologies (8.7% versus 27%). They were more likely to be referred to senior practitioners within the department (43% versus 33%), necessitated more frequent hospitalizations (33 cases versus 1), and required post-emergency follow-ups or referrals to hyper-specialized consultants.
Despite comprising a relatively small percentage of the total patient population, frequent users of ophthalmological emergency departments tend to present with more severe diagnoses. This underscores the importance of optimizing resources to alleviate some of the burden on specialized emergency services.
描述眼科急诊科常客的特征及管理模式，并与偶尔就诊的患者进行比较。
本研究对眼科急诊科2.5年期间的所有就诊情况进行回顾性分析。在此期间就诊4次或更多次的患者被确定为常客，并与从仅就诊一次的患者中随机选取的对照组进行比较。使用单变量和多变量分析方法，对与诊断相关的严重程度评分（范围为1至5分（基础评分））、临床特征及患者管理策略进行分析。
在18,802次就诊中，331名患者（占总数的2.23%）在2.5年期间被确定为常客，就诊次数从4次到23次不等。与对照组相比，常客年龄往往大10岁左右，诊断病情更严重（基础评分2.43±1.15对1.89±0.94，P = 6.35×10）。他们的就诊主要与非创伤性眼前节病变相关（56%对27%），而非创伤性病变（8.7%对27%）。他们更有可能被转诊至科室的资深医生处（43%对33%），需要更频繁的住院治疗（33例对1例），并且需要急诊后随访或转诊至高专科顾问处。
尽管眼科急诊科常客在患者总数中所占比例相对较小，但他们的诊断病情往往更严重。这凸显了优化资源以减轻专科急诊服务负担的重要性。
