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George Moussa, Jasvir Virdee, Mrinal Rana, Saaeha Rauz; Developing a Data Collection Tool to Determine the Epidemiology and Direct Cost Analysis of Microbial keratitis (MK) Admissions in the UK. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2139.
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© ARVO (1962-2015); The Authors (2016-present)
MK is the commonest ophthalmic emergency admission in the developed world, with large cost burden to the NHS. There are few prospective epidemiological studies. This study was set up to develop a data tool and to validate data fields on a series of retrospective patients that aims to determine epidemiological data for the Birmingham Midland Eye Centre (BMEC). This is to be developed as national data collection tool for MK admissions.
Data was collected retrospectively for a period of twelve months (Jan-Dec 2013) for 72 patients on a validated electronic proforma. Extensive demographic, clinical, microbiological and treatment data were collected through patient records.<br /> Direct cost of admission (COA) were calculated for individual patients including: Length of Stay in Days (LOS), topical medication, cost of microbiological services and cost of an ophthalmic hospital bed.
Demographic data consisted of 41(56.9%) female, 31(43.1%) male. Left eye: 32(44.4%), Right Eye: 39(54.2%), Bilateral: 1(1.4%). Contact lenses (CL) were used in 21(29.1%) of admissions. 34(51.5%) had ORF. The most common bacteriological flora consisted of Staphylococcus 11(15.3%), Streptococcus 10(13.9%), Pseudomonas 9(12.5%) and Moraxella 8(11.1%). Culture positive bacterial infections: 40(55.6%), gram positive 22(55%), gram negative 18(45%). The most commonly prescribed antibiotics on admission were: G.Ofloxacin 40(55.6%), G.Penicillin 25(34.8%) and G.Cefuroxime 22(30.6%) and G.Gentamicin in 7(9.7%). Most common antibiotics given subsequently after culture sensitivities were: G.Gentamicin 26(36.1%), G.Cefuroxime 18(27.8%), G.Ofloxacin 14(20.8%), G.Penicillin 14(20.8%)<br /> <br /> LOS (days) median 7. COA: Median £4362.94 (£1968-£29,676). LOS is main contributor to cost (r=1.0,p<0.0001). Median cost of drops £60(£1.44-£235.33). ̅Age and LOS showed no correlation (r=0.219, p=0.078). Long LOS (>=6 days), short LOS (< 6 days) found no significant difference between microbes on presentation (fishers exact test p=0.345).
These results echo the importance of a validated robust data capturing tool for essential epidemiological data. An incorporated cost analysis is vital to capture data for resource focus and enforcing effective and efficient practice. Having determined parameter fields in this study, we are developing a web-based input form for national data capture.
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