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Yssra Soliman, David Poulsen, Afshin Parsikia, JOYCE MBEKEANI; EPIDEMIOLOGY OF ORBITAL FRACTURES – ANALYSIS OF NATIONAL TRAUMA DATA BANK. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5942.
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Orbital fractures are leading injuries associated with major trauma and are potentially blinding. Understanding the epidemiology can help guide public health measures that target at-risk groups. We aim to evaluate epidemiologic patterns of orbital fractures in the US.
A retrospective evaluation of the National Trauma Data Bank (2008-2014) was conducted and patients with orbital injuries were identified using ICD9 codes. Statistical analysis of tabulated data was performed with SPSS software. Categorical and continuous variables were correlated using student t-test, chi-squared and odds ratios (OR) were calculated. Statistical significance was set at p<0.05.
124,887 patients from a total of 316,485 (39.5%) with ocular trauma were diagnosed with orbital fractures. The mean age was 43.0 years (SD 21.2) with a median of 41.0 years (IQR=25-57). 72.1% were males and 27.9% females. Race was documented as black 15.1%, white 67% and “other” 17.9%. Ethnicity was Hispanic in 11.3%. Geographic regions reporting most cases were South 37.3% and Midwest 22.8%. Frequent mechanisms were falls 24.6%, struck by against (SBA) 22.9% and motor vehicle occupant (MVTO) 19.8%. Mean injury severity score (ISS) was 14.9 (median 13.0; IQR 8-21). Males were younger (mean=40.3; CI 40.2-40.5) than females (mean=50.2; CI 49.9-50.5; p<0.001). Traumatic brain injury (TBI) occurred in 64.8% and was more likely to occur after motorcycle accidents than other mechanisms (OR=2.0; CI 2.0-2.2; p <0.001). The mechanism in blacks was most likely SBA (OR=2.3; CI 2.3-2.4) while in whites, falls (OR=2.3; CI 2.2-2.3) p<0.001. Blacks had greater odds of assault (OR=3.4; CI 3.3-3.6) and whites, unintentional (OR=2.8; CI 2.7-2.8) and self-inflicted injury (OR=1.9, CI 1.7-2.1) p<0.001. Falls were most common in those >65years (OR=18.0; CI 17.3-18.6); p <0.001. Falls also were more likely in the Northeast (OR=1.9; CI 1.8-1.9) P<0.001 and MVTO, in the South (OR=1.6; CI 1.5-1.6) p<0.001. Blunt trauma had greater odds of severe ISS (OR=1.3; CI 1.3-1.4) and penetrating trauma, very severe ISS (OR=3.7; CI 3.5-4.0) p<0.001.
Orbital fractures were most common in males and the majority had high ISS and associated TBI. Different mechanisms and intent associated with certain ages, races and regions underscore the need to develop targeted preventative measures to help reduce visual impairment.
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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