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LEDIANA GODUNI, David Poulsen, JOYCE MBEKEANI; EPIDEMIOLOGY OF OCULAR INJURIES IN MAJOR TRAUMA–THE BRONX EXPERIENCE. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3049.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular trauma is a leading cause of avoidable blindness in the USA. Population-based epidemiologic analyses are instrumental for developing targeted public health measures. We aim to evaluate types and mechanisms of ocular injuries and demographics of patients admitted for major trauma at a Level I trauma center for years 2008-2015.
Retrospective chart review of patients with ocular injuries in major trauma cases, submitted to the National Trauma Database, were identified using ICD-9 codes. Tabulated Excel data was statistically analysed and associations determined with two sample student-t test and Chi-square using STATA/MP-12 software. Statistical significance was set at p<0.05.
861 patients with ocular injuries from a total of 13,825(6.2%) admitted for major trauma were identified. The mean age was 47.2yrs (range 0.5-104) with a median of 44yrs (IQR=37.4). 608(70.6%) were male and 253(29.4%) female. Males were younger (42yrs) than females (59.7yrs). Race was documented as black, 222(25.8%), Caucasian 166(19.3%) and ‘other’ 450(52.3%). Of the total, 302(35.1%) identified as both ‘other’ race and Hispanic ethnicity, comprising the largest sub-group. Common mechanisms were falls (32.8%), struck by/against (SBA) (23.8%) and motor vehicle accidents (17.5%). On further breakdown, males had increased odds of SBA by 5.1(CI 3.1-8.3, p<0.001); females had increased odds of falls by 3.7(CI 2.7-5.0; p<0.001). Patients >60yrs had 18.6 increased odds of falls compared to younger age groups (CI 12.8-26.8, p<0.001). 60.7% were unintentional while 35.9% were due to assault. Frequent injury types were eye and adnexa contusions (57.9%), orbital wall fractures (30.7%) and open wounds of ocular adnexa (22.1%). Open globe injuries accounted for only 8.95%. Patients with orbital wall fractures were more likely to have high injury severity scores (ISS) (mean 13.5; CI 12.3-14.7; p<0.0001); open globe injuries were not associated with high ISS (mean 6.1; CI 4.7-7.6; p<0.0001).
In this population, ocular injuries occurred in a minority of admitted major trauma patients. Most injuries were unintentional and occurred between the third and fifth decade, in Hispanics and males. The mechanism was gender and age-dependent but for the whole group falls outnumbered other mechanisms. Ocular contusions and orbital wall fractures comprised the majority of injuries; the latter was associated with high injury severity scores.
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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