April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Orbital Fractures: National Inpatient Trends and Complications
Author Affiliations & Notes
  • Marcus J. Ko
    Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
  • Jonathan W. Kim
    Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
  • Robert Arrigo
    Outcomes Research Laboratory, VA Palo Alto Health Care System, Palo Alto, California
  • Eleonora M. Lad
    Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
  • Footnotes
    Commercial Relationships  Marcus J. Ko, None; Jonathan W. Kim, None; Robert Arrigo, None; Eleonora M. Lad, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 725. doi:
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      Marcus J. Ko, Jonathan W. Kim, Robert Arrigo, Eleonora M. Lad; Orbital Fractures: National Inpatient Trends and Complications. Invest. Ophthalmol. Vis. Sci. 2011;52(14):725.

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Abstract
 
Purpose:
 

To examine cost, demographics and short-term complications associated with orbital fractures and surgical repair in the inpatient population in the United States over a sixteen year period (1993-2008).

 
Methods:
 

A retrospective cohort study was performed by using the Nationwide Inpatient Sample (NIS) from 1993 to 2008 and searching the database for discharges classified with ICD-9 diagnosis codes of orbital fractures, orbital fracture repair, and associated diagnoses.

 
Results:
 

There was a nearly 60% increase in the annual number of orbital fractures over this period with 13,531 admissions in 1993 and 21,745 admissions in 2008. National demographics for patients with orbital fractures included 67% male, most commonly between 18-44 years of age (43%), with 75% of cases at large teaching hospitals. Hospital length of stay remained relatively constant over this period at approximately 3.4 days. However, charges increased considerably from $8245 in 1993 to $35,048 in 2008. Associated diagnoses included eyelid laceration (5%), commotio retinae (2.9%), and globe rupture (1.7%). Approximately 41% of patients underwent orbital fracture repair. Surgical patients were younger than non-surgical patients by approximately 10 years (mean age 31 vs 41 years). An overall complication rate of 4.8% was noted including: pulmonary (2.6%), renal (0.69%), wound complication (0.44%), strabismus (0.48%). Orbital fracture repair was associated with an extra day of hospitalization and $15,000 in hospital charges. The rate of pulmonary complications, wound complications and strabismus was higher in the patients undergoing orbital fracture repair (P<0.05).

 
Conclusions:
 

The number of orbital fractures has dramatically increased over the past decade and so has associated cost. Acute repair of orbital fractures is commonly performed and can be associated with a longer length of hospital stay, increased cost as well as higher rate of pulmonary complications, wound complications and strabismus. It is important to carefully weigh the risk/benefit profile and comorbidities in determining whether surgical intervention is recommended in orbital fracture patients.

 
Keywords: orbit • trauma 
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