Purchase this article with an account.
Kamyar Vaziri, Suzann Pershing, Thomas Arno Albini, Darius M Moshfeghi, Andrew A Moshfeghi; Risk Factors Associated With Developing Endogenous Endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3854.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate and identify the potential risk factors and loci of infection associated with developing endogenous endophthalmitis (EE) in patients with recorded hematogenous infections.
MarketScan Commercial Claims and Encounters, and Medicare Supplemental and Coordination of Benefit inpatient databases from the years 2007-2011 were obtained. Utilizing ICD-9 codes, multinominal logistic regression was used to identify potential predictors and risk factors for developing endophthalmitis in patients with bacteremia, septicemia and/or fungemia. Endophthalmitis in a patient with blood infection was considered to be EE.
Among inpatient population with hematogenous infections ((n= 261,796), co-diagnosis of HIV (OR=4.27;CI,1.55-11.8;p=0.005), tuberculosis (OR=8.5;CI,1.2-61.5;p=0.03), endocarditis (OR=8.3;CI,4.9-13.9;p<0.001), bacterial meningitis (OR=3.8;CI,1.2-12.0;p=0.023), fungal meningitis (OR=59.1;CI,14.1-247.8;p<0.001), internal organ abscess (OR=2.9;CI,1.2-6.4;p=0.02), lymphoma/leukemia (OR=2.9;CI,1.6-5.3;p<0.0001), skin abscess/cellulitis (OR=1.75; CI,1.1-2.8; p=0.02), pyogenic arthritis (4.2;CI, 1.8-9.6;p=0.001) and diabetes with ophthalmic manifestations (OR=7.0;CI,1.7-28.3;p=0.006) were all significantly associated with a diagnosis of EE. However, bacterial pneumonia (OR=0.61;CI,0.28-1.3;p=0.20), intestinal infections (OR=1.84;0.86-3.94;p=0.12), chronic kidney disease/renal failure (OR=0.99;CI,0.36-2.7;p=0.98) and malignancy (OR=1.1;CI,0.7-1.8;p=0.71) were not significantly associated with developing endophthalmitis in patients with blood infections. Furthermore, when compared to patients with hospital length of stay of 3 days or less, ones with length of stay of 3-10 days (OR=1.9;CI,1.1-3.3;p=0.01), 10-30 days (OR=3.1;CI,1.8-5.5;p<0.0001) and 31+ days (OR=5.3;CI,2.7-10.4;p<0.0001) were more likely to have a diagnosis of EE. Lastly, Individuals with ICU/NICU admission were also more likely to have EE (OR=1.5;CI,1.4-1.6; p<0.0001).
Among inpatient persons with hematogenous infections, we found that the odds of developing a diagnosis of endophthalmitis were significantly higher for patients with comorbidities including endocarditis, bacterial meningitis, lymphoma/leukemia, HIV/AIDS, internal organ abscess, diabetes with ophthalmic manifestations, skin cellulitis/abscess, pyogenic arthritis, and tuberculosis; patients with longer length of hospital stay; and patients with ICU/NICU admission.
This PDF is available to Subscribers Only