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LEDIANA GODUNI, David Poulsen, Afshin Parsikia, JOYCE MBEKEANI; CHARACTERISTICS OF OCULAR TRAUMA IN THE ELDERLY. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5944.
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The elderly population is rapidly increasing and is admitted with major trauma at rates in excess of their fraction of the population, often with poorer outcomes. Visual disability and blindness from ocular trauma impacts morbidity and mortality but is potentially preventable. We sought to evaluate the epidemiological characteristics of elderly ocular trauma in the US.
A retrospective study of the National Trauma Data Bank (2008-2014) was conducted and patients >65yrs with ocular trauma were identified using ICD-9 codes. Variables were correlated with student t-test and Chi-squared; additionally odds ratios were calculated, using SPSS software. Statistical significance was set at p<0.05.
58,074 patients, from a total of 316,485 patients (18.3%) with ocular trauma were >65yrs. The mean age was 77.5yrs (SD=7.4) with a median of 78yrs (IQR=71-84). Females (53.5%) outnumbered males (46.5%) and were also older (79 vs 75.8); p<0.001. Race distribution was White, 83.2%, Black, 5.7% and “other,” 11.1 %. Only 5% were Hispanic. The geographic regions reporting most cases were the South (31%) and the Northeast (26.6%). Frequent types of injury were contusion of the eye/adnexa (45.9%) and orbital fractures (37.7%). Associated traumatic brain injury (TBI) occurred in 62.6%. Mean injury severity score (ISS) was 12.9 (SD=9.2) and the mean length of hospital stay was 6.2days (SD=7.7). Mortality occurred in 6.7%. Common mechanisms were falls (71.6%) and MVT-occupant (11.1%). Common locations were home (50.1%), street (21.6%) and residential institutions (8%). Falls had greater odds of occurring in residential institutions (OR=8.3, CI=7.2-9.4; p<0.001). Falls also were more likely to result in a minor ISS (1-8) (OR=1.5, CI=1.5-1.7) while MVT-occupant, in very severe ISS (>24) (OR=2.1, CI=2-2.3); p<0.001. Whites had higher odds of falls (OR=1.68, CI=1.61-1.77) and Blacks, struck by against mechanism (OR=3.9, CI=3.5-4.4); p<0.001. The Northeast region had greater odds of falls (OR=1.6, CI=1.5-1.7) and the West, MVT-pedestrian accidents (OR=2.1, CI=1.8-2.3); p<0.001.
Ocular trauma in the elderly occurred most frequently in females who were older than males, resulting mostly from falls that occurred at home and residential institutions. Most patients had associated TBI. Identified gender, race and regional variances could assist in addressing modifiable risks and reducing disability in this growing and susceptible population.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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