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Craig S Schallhorn, Frank M. Bishop, Natalie A Afshari; Prevalence of ophthalmic diagnoses among hospital admissions in the Nationwide Inpatient Sample. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1388.
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To examine changes in prevalence of ophthalmic diagnoses among hospital admissions in a large administrative database
Retrospective analysis using the Nationwide Inpatient Sample for years 2000-2012. Inclusion criteria were ICD-9 diagnosis codes of ophthalmic disease. Primary outcome was annual change in prevalence of ophthalmic diagnoses during the study period. Patient demographic factors and comorbidities were included for analysis.
A total of 1945312 hospital admissions with associated ophthalmic diagnoses were captured for analysis. The population was 45% male, median age 70 (54-82), 68% white, 97% insured. The majority of the study group presented ophthalmic diagnoses as comorbid conditions, not primary admission diagnoses. Most common ophthalmic diagnoses were glaucoma (0.87% of all admissions), diabetic retinopathy (0.44%), conjunctivitis (0.18%), cataract (0.14%), and orbital fracture (0.10%). An increasing prevalence of ophthalmic conditions over the study period was observed in 12/24 of diagnoses, including cataract, conjunctivitis, corneal abrasion, glaucoma, herpes simplex keratitis, herpes zoster ophthalmicus, keratitis, optic neuritis, orbital fracture, primary malignancy of eye, retrobulbar hemorrhage, and strabismus. A decreasing prevalence was observed in 6/24, including chorioretinitis, corneal ulcer, hyphema, open globe, retinal detachment, and vitreous hemorrhage. A stable trend was observed in 6/24, including angle closure glaucoma, diabetic retinopathy, endophthalmitis, ischemic optic neuropathy, orbital cellulitis, and uveitis. Most common primary admission diagnoses within the study group were pneumonia, heart failure, and coronary artery disease. Comorbid diagnoses frequent in the study were hypertension, diabetes mellitus, and hyperlipidemia.
Over the study period, half of ophthalmic diagnoses increased in prevalence among hospital admissions; the rest demonstrated stable or decreasing prevalence. The increasing prevalence of ophthalmic diagnoses observed may reflect an aging population with systemic disease at risk for hospital admission. Future study will delineate additional factors that influence prevalence, such as cost and treatment patterns. The main limitation of this study is that inpatient ophthalmic diagnoses were principally comorbid conditions, not primary admission diagnoses.
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