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Sumarth Ketan Mehta, Tahreem Mir, Isaac G Freedman, Amar Sheth, Soshian Sarrafpour, Ji Liu, Christopher Teng; Characteristics of Nationwide ED Presentations of Acute Angle-Closure Glaucoma from 2008-2017. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1853.
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© ARVO (1962-2015); The Authors (2016-present)
Acute angle closure glaucoma (AACG) is an ophthalmologic emergency with a rising incidence in the United States. Nationwide data on the epidemiology and clinical characteristics of AACG are lacking despite the significant morbidity and costs associated with the condition. We performed a nationally-representative, retrospective cross-sectional study using the Nationwide Emergency Department Sample (NEDS).
NEDS was queried by ICD-9/10 code for cases of AACG in a ten-year study period from 2008 to 2017. Cases with AACG as primary ED diagnosis were included. Weights specified in NEDS were used to compute nationally representative estimates. Linear regression analysis and seasonality (Edwards and Hewitt's) tests were used to identify significant trends. Reported outcomes include trends in the incidence, demographics, seasonality, and economic impact of AACG.
A total of 29,645 AACG related ED visits were identified nationally over the study period. AACG was found to occur most frequently among female patients in the seventh decade of life. Incidence increased significantly over the study period (average increase of 0.044 cases per 100,000 individuals per year, p=0.01). The most common systemic comorbidity was hypertension, and the most common procedures were iridotomy and iridectomy. The Northeast U.S. geographic region had the highest average incidence of AACG (1.18 per 100,000), followed by the West (0.96 per 100,000), South (0.93 per 100,000), and Midwest (0.73 per 100,000). Significant seasonal variation was seen nationally and in each region (p<0.01), with increased national incidence from July to December (p=0.048). Inflation adjusted charges associated with AACG related ED visits over the study period totaled $152.8 million.
The rising incidence of AACG poses an increasing burden on the U.S. healthcare system. High-risk groups that may benefit most from preventative strategies include women, individuals of low socioeconomic status, and those between ages 50 and 70. Ophthalmologists should be aware of significant regional and seasonal trends in the presentation of AACG.
This is a 2021 ARVO Annual Meeting abstract.
The incidence of AACG in the United States increased in the years from 2008 to 2017. The dashed line represents a significant regression analysis (slope = 0.044 cases per 100,000 individuals per year, p=0.01).
Trends in Inflation-Adjusted Total Annual Charges for ED Visits with AACG as Primary Diagnosis
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