Ripa Matteo, Khade Gaurav, Shah Neeraj Apoorva
Department of Ophthalmology, Sankara Eye Hospital, Jaipur, 302039, Rajasthan, India.
Int Ophthalmol. 2025 Jun 20;45(1):255. doi: 10.1007/s10792-025-03632-0.
To investigate the main reasons related to non-surgical discharge (NSDS) among patients recruited for cataract surgery in the Northwest Indian screening camps (SCs) and evaluate the potential actions that could be undertaken to improve the SC programs in India.
Retrospective cross-sectional analysis of patients' medical records selected for elective cataract surgery at Sankara Eye Hospital, a tertiary eye care center in Jaipur, Rajasthan, between January 1 and December 31, 2023. After SCs' thorough examination, recruited patients suitable for cataract surgery were further evaluated in the hospital to assess anesthetic and ophthalmic suitability. Reasons for NSDS, classified as patient-related, administrative-related, and anesthesia-related, were recorded. Univariate and multivariablelogistic regression were conducted to evaluate the effects of statistically significant variables on the reasons for NSDS.
13,219 patients were recruited from screening to undergo cataract surgery. Of 13,219, 1036 (7.8%) were discharged without surgical interventions. Patient-related reasons accounted for 57.14% of total causes, with 301 (29.06%) patients refusing to consent to surgery. 78 patients (7.5%) were discharged due to the lack of the required intraocular lens, whereas 288 patients (27.8%) reported a blood pressure > 140/90 mmHg, whereas 22 (2.1%) were discharged due to uncontrolled diabetes. Patients aged 65 years or older had 1.61-fold greater odds of being discharged due to anesthesia-related causes (95% Confidence Interval [CI]: 1.23-2.10, p < 0.001) compared to patients aged less than 65 years.
Albeit rare, NSDS-related factors should be considered to better counsel patients in SCs and prevent avoidable blindness in India.
调查印度西北部筛查营地（SCs）中招募的白内障手术患者非手术出院（NSDS）的主要相关原因，并评估为改善印度筛查营地项目可采取的潜在行动。
对2023年1月1日至12月31日期间在拉贾斯坦邦斋浦尔的三级眼科护理中心桑卡拉眼科医院选择进行择期白内障手术的患者病历进行回顾性横断面分析。在筛查营地进行全面检查后，招募的适合白内障手术的患者在医院进一步评估麻醉和眼科适宜性。记录非手术出院的原因，分为与患者相关、与行政相关和与麻醉相关。进行单变量和多变量逻辑回归以评估统计学上显著变量对非手术出院原因的影响。
从筛查中招募了13219名患者接受白内障手术。在这13219名患者中，1036名（7.8%）未经手术干预即出院。与患者相关的原因占总原因的57.14%，其中301名（29.06%）患者拒绝同意手术。78名患者（7.5%）因缺乏所需的人工晶状体而出院，而288名患者（27.8%）报告血压>140/90 mmHg，22名患者（2.1%）因糖尿病控制不佳而出院。与年龄小于65岁的患者相比，65岁及以上的患者因麻醉相关原因出院的几率高1.61倍（95%置信区间[CI]：1.23 - 2.10，p < 0.001）。
尽管罕见，但应考虑与非手术出院相关的因素，以便在筛查营地更好地为患者提供咨询，并预防印度可避免的失明。
