Malek Davina A, Greenfield Jason A, Norris Timothy, Swaminathan Swarup S, Cavuoto Kara M
Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
University of Miami Miller School of Medicine, Miami, Florida.
Ophthalmol Sci. 2025 Apr 24;5(5):100802. doi: 10.1016/j.xops.2025.100802. eCollection 2025 Sep-Oct.
To evaluate the impact of Social Vulnerability Index (SVI) and the distance to a tertiary eye emergency department (ED) on presenting visual acuity (VA), final VA, and rates of VA change over time in patients presenting with open globe injury (OGI).
Retrospective cohort study.
Patients with OGI from 2018 to 2021 were identified from the electronic health records using the International Classification of Diseases coding system.
Data collected included demographics, insurance status, follow-up visits, and VA measurements. Social Vulnerability Index scores were calculated using a US Census Geocoder and stratified into quartiles, and distances to the eye ED were calculated. Simple logistic regression models evaluated the associations of presenting and final VAs with SVI, distance, baseline characteristics, and time from injury to presentation, adjusting for potential confounders. Univariable and multivariable linear regression models analyzed the associations between VA rates of change over time and SVI, distance to ED, demographics, insurance, and presenting VA.
The relationship between SVI and distance on presenting VA, final VA, and rates of longitudinal VA change over time.
A total of 446 patients presented with an OGI. Of these patients, 337 (75.0%) with complete SVI data were included in the final analysis. Social Vulnerability Index was associated with nearly a fourfold increased risk of worse presenting VA in populations with higher vulnerability compared with those with lower overall vulnerability (odds ratio [OR] = 3.85; 95% confidence interval [CI]: 1.34-11.05; = 0.012). Greater distance from the eye ED was also a contributing factor to higher risk of poorer presenting VA (OR = 2.55; 95% CI: 1.42-4.60; = 0.002). On multivariable analyses, longitudinal VA change over time was not impacted by SVI ( > 0.05 for all groups), and final visual outcome was not associated with either SVI or distance to the eye ED.
Greater distances from the eye ED and social vulnerability were associated with a higher risk of worse VA at presentation. However, no significant impact of SVI or distance was observed on long-term VA changes and final visual outcome on the multivariable analyses.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
评估社会脆弱性指数（SVI）以及与三级眼科急诊科（ED）的距离对开放性眼球损伤（OGI）患者就诊时视力（VA）、最终视力以及随时间的视力变化率的影响。
回顾性队列研究。
使用国际疾病分类编码系统从电子健康记录中识别出2018年至2021年患有OGI的患者。
收集的数据包括人口统计学信息、保险状况、随访就诊情况以及视力测量值。使用美国人口普查地理编码器计算社会脆弱性指数得分并分层为四分位数，计算到眼科急诊科的距离。简单逻辑回归模型评估就诊时和最终视力与SVI、距离、基线特征以及受伤至就诊时间之间的关联，并对潜在混杂因素进行调整。单变量和多变量线性回归模型分析随时间的视力变化率与SVI、到急诊科的距离、人口统计学、保险以及就诊时视力之间的关联。
SVI和距离与就诊时视力、最终视力以及随时间纵向视力变化率之间的关系。
共有446例患者出现OGI。其中，337例（75.0%）有完整SVI数据的患者纳入最终分析。与总体脆弱性较低的人群相比，社会脆弱性指数与脆弱性较高人群中就诊时视力较差的风险增加近四倍相关（优势比[OR]=3.85；95%置信区间[CI]：1.34 - 11.05；P = 0.012）。距离眼科急诊科较远也是就诊时视力较差风险较高的一个因素（OR = 2.55；95% CI：1.42 - 4.60；P = 0.002）。在多变量分析中，随时间的纵向视力变化不受SVI影响（所有组P>0.05），最终视力结果与SVI或到眼科急诊科的距离均无关联。
距离眼科急诊科较远和社会脆弱性与就诊时视力较差的风险较高相关。然而，在多变量分析中，未观察到SVI或距离对长期视力变化和最终视力结果有显著影响。
作者对本文讨论的任何材料均无专有或商业利益。
