Abstract
Purpose :
Endophthalmitis represents a devastating and rare complication of eye trauma. Most studies assessing the risk and incidence of post-traumatic endophthalmitis have been limited to single center studies within the same hospitalization. We performed a retrospective cohort analysis of a large national cohort of patients to evaluate the incidence and risk factors for hospital readmission related to post-traumatic endophthalmitis.
Methods :
The 2010-2014 National Readmissions Database (NRD) was queried for this study. The NRD is drawn from the Healthcare Utilization Project State Inpatient Databases and was formed to create nationally representative information on hospital readmissions. All patients with a diagnosis of open wound to the eyeball (ICD-9 code 871.X) were included in this analysis. The primary outcome of our study was endophthalmitis during initial admission (ICD-9 code 360.19). The secondary outcome of our study was readmission to the hospital within 30 days of discharge. For readmission analysis, patients who died during their initial hospitalization or were admitted in December were excluded from the analysis, as 30 day follow-up could not be obtained for these patients. Analysis was weighted to create nationally representative samples. All analysis was conducted on SAS 9.4 (Cary, NC).
Results :
A total of 22,488 patients were admitted to the hospital with open wound to eye in the United States from 2010-2014. Endophthalmitis occurred in 58 (.26%) of these patients. Among the 19,992 patients who were included in 30 day readmissions analysis, 1577 (7.9%) were readmitted within 30 days. New onset endophthalmitis occurred in 21 (1.3%) of all readmissions. Patients who were younger (46.5 vs. 51.4, p = .0002) or had diabetes with chronic complications (1.0% vs. .24%, p = .03) were significantly more likely to develop endophthalmitis.
Conclusions :
Using a large nationally representative cohort of patients, we demonstrate a small, but significant risk of endophthalmitis in patients with open wound to eye even after hospital discharge. Despite our advances in ocular trauma, it remains that there is no standardized approach in our treatment of open globe injury. This study highlights an opportunity to create a standardized protocol for the care of patients with open globe injury, both during the acute and post-acute period.
This is a 2020 ARVO Annual Meeting abstract.