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Marko Oydanich, Ibraheem S Shaikh, Musa S Shaikh, Albert S Khouri; Assessing the Risk of Vitreous Hemorrhage Following Mechanical Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3631.
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A broad range of complications may present following mechanical vitrectomy (MV), including vitreous hemorrhage (VH), cataract formation, and endophthalmitis. Using a large sample population database, we investigated the impact of MV along with other clinical and non-clinical factors on the risk of developing VH.
Cases of MV were obtained from the National Inpatient Sample (NIS) database between 2002 and 2013 using ICD-9 codes. Associated morbidities and procedures were assessed in cases labelled with a principal procedure of MV and a non-primary diagnosis of VH. Perioperative complications occurring during the same operative admission were abstracted using secondary ICD-9 diagnosis codes. Univariate and multivariate logistic regression analyses were carried out in MV cases to determine risk factors for the development of VH. The data was weighted using the NIS-provided discharge-level weights in order to generate nationally representative estimates. The Bonferroni correction method was applied to decrease risk of type II errors.
There were 3,927 MV cases identified in the dataset. These were divided into vitreous hemorrhage (n=610, median age = 55, 52% male) and non-vitreous hemorrhage (n=3,317, median age = 57, 51% male) cohorts. Factors associated with increased risk of vitreous hemorrhage included diabetes with chronic complications (OR=2.02), renal failure (OR=1.60), congestive heart failure (OR=1.56), and obesity (OR=1.58). Demographic factors were analyzed and showed that, relative to white cases, there was an increased risk of VH in Black (OR=1.52), Hispanic (OR=1.43), and Asian (OR=1.80) cases. Confidence intervals can be seen in Figure 1.
Retrospective analysis of a large patient population showed that the risk of VH following MV is increased in cases with complicated diabetes, renal failure, congestive heart failure, and obesity. Black, Hispanic, and Asian cases were also independently associated with an increased risk of VH. Limitations of this study include its inability to demonstrate temporal relationships due to its retrospective nature, a database that records cases rather than individual patients, and the limited cases of MV that occur in inpatient settings.
This is a 2021 ARVO Annual Meeting abstract.
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