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Alisha Prystowsky, David Poulsen, Afshin Parsikia, JOYCE MBEKEANI; CHARACTERISTICS OF OPEN GLOBE INJURIES USING NATIONAL TRAUMA DATA. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5945.
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© ARVO (1962-2015); The Authors (2016-present)
Open globe injuries (OGI) are leading causes of avoidable blindness. Increasingly sophisticated surgical interventions have been devised but prevention remains the best option. We sought to study the epidemiological patterns of OGI in the US.
A retrospective evaluation of the National Trauma Data Bank (2008-2014) was conducted and ICD-9 codes were used to identify OGI. The tabulated data was statistically analyzed with SPSS software using t-test and chi-squared. Odds ratios were calculated; statistical significance was set at p<0.05.
29,905 from a total of 316,485 patients (9.45%) with ocular trauma had OGI. The mean age was 38.9yrs (SD=22.7) with a median of 36yrs (IQR=21-54). 75.2% were males who were younger (mean=37.1yrs) than females (mean=44.8yrs); p<0.001. Documented race was Black 20.9%, White 57.7% and “other” 21.4%. Ethnicity was Hispanic in 15.2%. Regions reporting the most OGI were the South (43.1%) and Midwest (22.6%). Mean hospital stay was 5.1 days (SD=9.6) and mean injury severity score (ISS) was 9.4 (SD=10.3). Blunt trauma (61.9%) was associated with moderate ISS (OR=1.8; CI 1.7-2) and penetrating trauma (18.9%) with very severe ISS (OR=2; CI 1.9-2.2); p<0.001. Frequent mechanisms were struck by against (SBA) 23.1%, falls 17.1%, motor vehicle trauma (MVT) occupant 13.1% and firearms 10.1%. The 21-64yrs group had greater odds of motorcycle accidents (OR 4.9; CI 3.8-6.3) and the elderly (>65), falls (OR 20.3; CI 18.8-22); p<0.001. Frequent locations were home, 36.2% and street, 25%. Frequent associated injuries were open wound of ocular adnexa (17.3%), orbital fractures (15%) and contusion of the eye/adnexa (14.9%). Associated traumatic brain injury (31.8%) was more likely in the >65yrs group (OR=1.3; CI 1.2-1.4) and MVT-pedestrian (OR=4.0; CI 3.2-4.9); p<0.001. Whites had greater odds of falls (OR=2.2; CI 2.1-2.4), unintentional (OR=2.8; CI 2.6-3) and self-inflicted injury (OR=3.3; CI 2.7-3.9), while Blacks had greater odds of SBA (OR=1.6; CI 1.5-1.7) and assault (OR=4.2; CI 3.9-4.5); p<0.001. The Northeast had greater odds of falls (OR=1.9; CI 1.7-2) and MVT-Pedestrian (OR=1.6; CI 1.3-2.1); p<0.001.
Open globe injuries occurred mostly in young working age males; the majority were from SBA and falls. We identified demographic and regional differences that could be used to develop multi-faceted, focused interventions to prevent unnecessary vision loss.
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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