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Sheel Rajoo Patel, Catherine He, Moshe Szlechter, Afshin Parsikia, JOYCE MBEKEANI; Mechanisms of Injury in Mortality-Related Ocular Trauma in the United States. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2105.
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Previous reports addressing mortality in Ophthalmology have dealt with studies of various stages of diabetic retinopathy. We aim to describe the mechanisms of mortality-related ocular trauma.
A retrospective study of mortality-related ocular trauma was conducted using the National Trauma Data Bank (2008-2014). Patients were identified using ICD-9 codes. Statistical analysis using student t-test, chi-squared and odds ratios (OR) calculations were performed with STATA software. Statistical significance was set at p<0.05.
12,233 (3.86%) of 316,485 patients were documented with mortality-related ocular trauma. The mean (SD) age was 50.1(25.5) yrs. Most patients were male (70.3%), white (71.8%) and from the South (37.7%). Frequent types of injury were contusion of the eye/adnexa (41.9%), orbital injuries (39.1%), and open ocular adnexa wounds (12.4%). Mean (SD) injury severity score was “very severe” at 29.8 (13.4) and Glasgow Coma Score, 6.9 (4.8). Most injuries (76.7%) were due to blunt trauma. Common mechanisms were falls (29.7%), motor vehicle-occupant (21.9%) and firearms (11.5%). Intentions were unintentional (75.9%), assault (12.1%), and self-inflicted (7.3%). Males had higher odds of injury from motorcycles (OR=4.05, CI 3.25-5.09) while females had higher odds from falls (OR=2.18, CI 2.0-2.36). Patients <21yrs were most likely to suffer MVT-occupant (OR=1.58, CI 1.41-1.78), the 21-64yrs, MVT-cyclist (OR=7.30, CI 5.95-9.00) and >65yrs, falls (OR=13.69, CI 12.39-15.13); p<0.001. Whites had greater odds of injury from falls (OR 2.32, CI 2.09-2.56), while blacks had greater odds of injury from firearms (OR 2.73, CI 2.36-3.16) and both Hispanics, (OR=1.69, CI 1.40-2.05) and Asians (OR=2.08, CI 1.43-2.95), MVT-pedestrian injury; p<0.001. Patients injured by firearms had the highest odds of death within a day of hospitalization (OR=3.19, CI 2.85-3.59) while patients injured by struck by/against were most likely to be hospitalized for >6 days (OR=1.52, CI 1.21-1.89); p<0.001.
Mortality-related ocular trauma was commonly caused by falls, MVT-occupant and firearms. Firearms lead to the most rapid demise. We noted demographic differences in mechanisms of injury that may be useful in developing focused measures aimed at preventing trauma-related deaths.
This is a 2020 ARVO Annual Meeting abstract.
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