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Kalla Alexis Gervasio, Albert Ya-Po Wu; Orbital fracture management and race. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3046.
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© ARVO (1962-2015); The Authors (2016-present)
While differences in orbital blowout fracture locations have been described between races, few studies have shown whether there are racial disparities in orbital fracture management. The purpose of this retrospective cohort study was to assess whether there are racial differences in orbital fracture injury mechanisms, time of presentation, and hospital course in an urban medical center in Queens, NY.
The Elmhurst City Hospital Trauma Registry was queried for ICD-9 codes for orbital fractures. Between January 1, 2000 and June 30, 2012, we identified 807 patients self-reporting as White, Black, Hispanic, or Asian with one or more orbital fractures. Differences in demographics, injury mechanism, and management were analyzed between races. The cutoff for p-value significance was less than 0.05.
The majority of patients were Hispanic (52.8%), followed by White (26.5%), Asian (11.8%), and Black (8.9%). Average age for all patients was 45. Minority patients were significantly younger: Hispanic (39.9), Black (41.9), and Asian (45.5), compared with Whites (56.1) (p < .0001). The majority of patients were male (81%), but females were more likely to be White (p < .0001). Mechanism of injury for Hispanic and Black patients was more likely to be assault, while falls were more likely in White and Asian patients (p < .0001). White patients had the longest average hospital stay at 10.65 days, while Hispanic patients had the shortest at 7.06 days (p = .009). Hispanic and White patients were more likely to be admitted to the ICU (p = .03), with White patients averaging the greatest number of ICU days at 6.84 (p = .004). White patients were also more likely to be discharged to rehab facilities than minorities (p < .0001). Black patients were more likely to have orbital floor fractures (p = .005). There were no racial differences in prevalence of orbital roof (p = .07) or orbital wall fractures (p = .36), month of presentation (p = .24), average injury severity score (p = .29), or admitting hospital service (p =.15).
This study demonstrates racial disparities in hospital course and discharge disposition for patients with orbital fractures. Minority patients tend to be younger and to incur assault more often than White patients. Despite no differences in associated injury severity scores, minorities with orbital fractures have shorter hospital stays and are less likely to be discharged to rehab facilities than White patients.
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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