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David Poulsen, LEDIANA GODUNI, Afshin Parsikia, JOYCE MBEKEANI; Characteristics of Ocular Trauma in the United States. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5947.
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Eye trauma is an important cause of blindness in the US and is largely preventable. An increased understanding of its epidemiology can guide the development of public health measures that target at-risk groups. We aimed to study national patterns of ocular trauma.
A retrospective review of the National Trauma Data Bank (2008-2014) was conducted. Patients with ocular trauma were identified using ICD-9 codes. Statistical analysis was performed with SPSS software. Student's t-test, Chi-squared and odds ratios (OR) were used to assess correlation of variables. Significance was set at p<0.05.
316,485 (5.93%) from a total of 5,336,575 patients, admitted with major trauma, had ocular trauma. The mean age was 41.8 yrs (SD=23; median=40 yrs; IQR=23-58). The majority were males (69.4%) who were younger (mean=39.2 yrs) than females (mean=47.9 yrs); p<0.001. Race distribution was White 66.1%, Black 15.1%, and “other” 18.9%. Mean hospital stay was 6.2 days. Frequent injuries were orbital fractures, 39.5% and contusions of eye/adnexa, 34%. Open globe injuries occurred in 9.4% with increased odds of occurring in Blacks (OR=1.6 CI 1.5-1.6; p<0.001). Associated traumatic brain injury occurred in 58.2%. Frequent mechanisms were falls, 25.5%, motor vehicle accident-occupant (MVTO), 21.8% and struck by/against (SBA), 17.6%. The majority of injuries occurred on the street, 40.8% and at home, 27%. Those <21 yrs had increased odds of MVTO (OR=1.5 CI 1.5-1.6), 21-64 yrs, SBA (OR 2.8 CI 2.7-2.9), and >65 yrs, falls (OR=16.8 CI 16.3-17.1); p<0.001. SBA had increased odds of occurring in public buildings (OR=2.8 CI 2.7-2.9) and falls, at home (OR=7 CI 6.9-7.1); p<0.001. Blacks were more likely to suffer SBA (OR=2.3 CI 2.3-2.4) and assault (OR=3.4 CI 3.3-3.5); p<0.001 and Whites, falls (OR=2.3 CI 2.3-2.4) and unintentional injury (OR=2.8 CI 2.7-2.8); p<0.001. The Northeast US had greater odds of falls (OR=2 CI 1.9-2) and the West, MVT-pedestrian (OR=1.5 CI 1.5-1.6); p<0.001. In work-related (industry, mine or farm) injuries, eye protection was used in only 1.8%.
Ocular injuries occur in a minority of patients admitted for major trauma in the US. Male preponderance and falls, MVTO and SBA mechanisms comport with previous reports. We identified particular regional and demographic patterns in mechanisms and settings that underscore the need to better understand reasons for these patterns and develop group-specific prevention measures.
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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