Abstract
Purpose :
Periorbital and ocular trauma from falls are leading causes of vision loss in the geriatric population. A breakdown of intrinsic protective mechanisms increases the likelihood of sustaining a periocular injury. The aim of this study is to improve preventative healthcare in the geriatric population. This study investigates if periocular trauma is a precursor or surrogate for a decline in health leading to increased mortality in the geriatric population.
Methods :
This is a retrospective case-control study using data from the I2B2 Carolina Data Warehouse. Patients over the age of 65 who sustained ocular and periocular trauma from April 2011 to June 2016 were evaluated. Controls included patients of similar age who underwent cataract surgery and had no history of ocular trauma presenting from April 2014 to June 2016. Patients who sustained significant multisystem trauma and died within one month of trauma were excluded. Mortality rates and statistical analysis including 2 sample t-tests with Bonferonni correction based on patient age and sex were conducted.
Results :
The study population includes 602 eligible patients over the age of 65, and the control population includes 1066 patients of similar age. In the ocular trauma group, 68 of the 602 patients died within 5 years, resulting in a mortality rate of 11.30%. In the control group, 69 out of 1066 patients died within 5 years, resulting in a mortality rate of 6.47%. There was a noticeable spike in 1 year mortality rate for the study group as opposed to controls. In the ocular trauma group, the mortality rates for patients with heart failure, dementia, Alzheimer's disease, degenerative diseases of nervous system, and vascular disease were 0.67, 0.92, 0.67, 0.72, and 0.73, respectively while the mortality rates for control patients with the same comorbidities remained at 0. When controlled for age, we found that in the study group, only patients aged 70-89 had a statistically significantly higher mortality rate.
Conclusions :
Geriatric patients who sustain periorbital trauma are almost twice as likely to die within five years compared to age-matched controls. Furthermore 70-89 year old patients with a history of ocular trauma have greater mortality rates than control patients. This study suggests that periocular trauma in the geriatric population may be an early indicator of a decline in health and these patients may benefit from closer surveillance.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.