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Isaac Chocron, David Poulsen, LEDIANA GODUNI, JOYCE MBEKEANI; CHARACTERISITICS OF OCULAR TRAUMA IN ELDERLY PATIENTS OF THE BRONX. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3050.
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© 2017 Association for Research in Vision and Ophthalmology.
Elderly patients admitted for major trauma may have associated ocular injuries, a leading cause of avoidable blindness. Analysis of the characteristics of ocular injuries in this sub-population will assist in establishing resource allocation and developing preventative measures. The purpose of this study is to evaluate patient demographics and types, mechanisms and locations of trauma presenting to a Level I trauma center.
Retrospective chart review of patients >65yrs with ocular injuries in major trauma cases, from years 2008 to 2015, identified using ICD-9 codes. Tabulated Excel data was statistically analyzed with student-t and Χ2 tests, using STATA/MP-12 software. Statistical significance was set at p<0.05.
221 elderly patients, from a total of 861 (25.7%) with ocular injuries, were admitted with major trauma. The mean age was 80.3yrs (range: 65-104) with a median of 79.2yrs (IQR=15.4). 40.7% were male and 59.3%, female. Males were younger (mean=77.3; CI=75.5-79.1) than females (mean=82.4; CI=80.8-83.9; p<0.0001). Race was documented as black (13.6%), Caucasian (30.8%) and ‘other’ (54.3%). 67.5% of the ‘other’ (36.7% of the overall total) identified as Hispanic. The most frequent types of injuries included contusion of the eye and adnexa (68.2%), orbital wall fractures (OWF) (22.2%) and open wound of ocular adnexa (18.1%). Open globe injuries accounted for only 6.3%. Males had 2.64 increased odds of having OWF than females (CI=1.38–5.05; p<0.003). Those with OWF had higher injury severity scores (ISS) (CI=14.1-20.9) than those without (CI=6.8-8.6; p<0.0001). 90.9% were unintentional and 4.98% due to assault. Common mechanisms of injury were falls (77.8%) and pedestrian motor vehicle accidents (6.8%). Documented locations of falls were at home (51.7%), the street (13.9%) and hospital/nursing homes (12.2%). Those falling at home were older (CI=81.8-85.4) than those at other locations (CI=77.0-80.6; p<0.0002).
In this population of elderly patients, ocular injuries occurred in females more often than males. The most common injuries were adnexal contusions and OWF; the latter occurred mostly in males and was associated with higher ISS. Falls accounted for the vast majority of injuries, occurring frequently at home and hospital/nursing homes. Public health measures addressing identifiable risks at these sites would likely be most beneficial in reducing ocular injuries in this age group.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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