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Aditya Uppuluri, Marco A Zarbin, Neelakshi Bhagat; Geographic Trends in Adult Open Globe Injuries (OGIs). Invest. Ophthalmol. Vis. Sci. 2020;61(7):2110.
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© ARVO (1962-2015); The Authors (2016-present)
To identify geographic trends in demographic variables, cost, and management of adult OGIs in the United States from 2002-2014.
We used the 2002-2014 National Inpatient Sample (NIS) Database in conjunction with diagnosis codes from the International Classification of Diseases, Ninth Revision to identify cases with a primary diagnosis of OGI. Once we identified all cases of OGIs, we removed the pediatric cases (0-20 years of age) and divided the adult data into four geographic regions as supplied by the NIS Database: Northeast, Midwest, South, West. Cases in these regions were compared with respect to sex, race, age, ocular findings, ocular surgeries, and cost of admission.
We identified 34,485 weighted cases of adult OGIs occurring between 2002-2014 (8457 in the Northeast, 6072 in the Midwest, 12264 in the South, and 7692 in the West). The ratio of men to women was roughly 2.33 to 1 across all geographic regions. The South had the highest rate (42.0%) of OGIs occurring in patients 21-40 years of age and the West had the highest rate (18.0%) of OGIs occurring in patients over 81 years of age. Penetrating injuries were the most common types of OGI seen in all regions (82.0-85.7%), and rates of intraocular foreign bodies (IOFBs) were between 11.9% and 12.9%. Rates of endophthalmitis were highest in the Midwest and South (1.9%). The prevalence of concurrent orbital fractures was highest in the Midwest (11.1%). The rates of vitrectomy and enucleation ranged from 12.4% to 14.2% and 2.7% to 5.5%, respectively. The average length of stay was 2-3 days in all regions. The average cost per day was highest in the West ($18,140.30).
In our analysis of the NIS Database, we found that the South had the highest prevalence of OGIs between 2002 and 2014. The ratio of men to women and the breakdown of OGIs by age group (21-40, 41-60, 61-80, and 81+) were both similar across geographic regions. The prevalence rates of penetrating injuries, IOFBs, and ruptures in all four regions were comparable. The prevalence of endophthalmitis and orbital fractures was highest in the Midwest and South. Rates of pars plana vitrectomy were consistent throughout the United States, but rates of enucleation were higher in the Midwest and South. While the average length of stay was comparable across the regions, the average cost per day was 37-50% greater in the West as compared to other regions.
This is a 2020 ARVO Annual Meeting abstract.
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