Abstract
Purpose :
To identify risk factors for enucleation in pediatric OGIs in the United States from 2002-2014.
Methods :
We utilized the National Inpatient Sample (NIS) Database to identify pediatric cases (age < 21 years) of OGIs from 2002-2014. Chi Square Testing was performed to evaluate for differences between enucleated and non-enucleated eyes. Univariate and multivariate analysis were performed to identify risk factors for enucleation. Statistical analysis was performed using IBM SPSS 23. P-values of less than 0.005 (after Bonferroni Correction) were considered statistically significant.
Results :
In total, 13,587 OGIs were identified in the pediatric population, with 76.5% occurring in males. Enucleation was performed in 4.2% OGIs; 85.2% of enucleated OGIs occurred in males and 14.8% in females. The average age of enucleated individuals was 15.50 years (SD = 4.34), and 5.9% of enucleations occurred in the 0-5 group, 6.8% in the 6-10 group, 23.5% in the 11-15 group, and 63.8% in the 16-20 group. The racial breakdown of enucleations was 85.2% white, 36.0% black, 20.3% Hispanic, 7.6% Asian/Pacific Islander, and 3.1% other. In addition, 51.6% of enucleations post-OGI presented as penetrating OGI without IOFB, 23.2% with IOFB, 34.9% with rupture OGI, 3.0% with endophthalmitis, 1.7% with vitreous hemorrhage, 4.6% with retinal detachment, and 0.9% with phthisis. The age groups 11-15 (OR = 3.62, p < 0.001) and 16-20 (OR = 4.95, p < 0.001), and racial identification as black (OR = 2.60, p < 0.001), Hispanic (OR = 1.53, p = 0.003), and Asian/Pacific Islander (OR = 4.43, p < 0.001) were significant predictors for enucleation. For ocular conditions and systemic comorbidities, significant risk factors for enucleation included penetrating OGI with an IOFB (OR = 2.53, p < 0.001), rupture OGI (OR = 6.15, p < 0.001) and depression (OR = 6.66, p < 0.001). The average length of stay and the average cost per day for enucleated patients was 9.3 days and $12,118.94, respectively.
Conclusions :
Enucleations were more common in male than female OGIs. OGIs in subjects in the 11-15 and 16-20 age groups, being of Black, Hispanic, or Asian/Pacific Islander race, presence of an IOFB, and rupture type of OGI were more likely cohorts to undergo enucleation for OGI. The average length of stay for enucleations was longer than for non-enucleations. Depression was seen six times higher in subjects that underwent enucleation than those who did not.
This is a 2020 ARVO Annual Meeting abstract.