Abstract
Purpose :
Current United States (US) epidemiologic studies on rhegmatogenous retinal detachment (RRD) are limited to specific geographic regions; we investigated the incidence, demographics, and economic burden of patients with RRD in the US emergency department (ED) setting.
Methods :
A retrospective cross-sectional study of adults with RRD sampled in the Nationwide Emergency Department Sample (NEDS) databases between January 1, 2016, and December 31, 2019, was conducted. The international classification of diseases, tenth revision, and current procedural terminology codes were used to identify RRD related visits. Annual incidence and demographics of patients with RRD, total and mean hospital charges and costs of RRD ED management were the primary outcomes. Multivariable logistic regression models were used for statistical analysis, and a p-value of ≤ 0.05 was considered statistically significant.
Results :
We identified 12,492 RRD cases aged ≥18 during the 4 years. Most cases occurred among males (8008/12942 [64%]) and individuals aged 50-64 (6155 /12492 [49.3%]). Most visits were to a metropolitan teaching hospital (11239 [90%]) and the south region (7003 [56.1%]), and approximately half of them had private insurance (5606/12492 [44.9%]). Only 177 (1.4%) visits occurred in a rural hospital. There was no seasonal variation in RRD incidence. Of all patients, 2920 (23.4%) had RRD repair at the same ED (emergency department) visit. The most common repair procedure was pars plana vitrectomy (2040 [69.8%]), followed by scleral buckling (315 [10.8%]) and complex retinal detachment repair (194 [6.6%]). Caucasians were more likely to receive treatment in the same ED visit compared to other races (odds ratio 3.85, 95% CI 1.75-8.47; p = 0.001), but there was no gender selection bias in the decision to repair RRD during the same ED visit (p = 0.388). The average incidence of RRD per 100,000 ED visits was 2.7. Hospital charges adjusted for inflation rose consistently from $23,600 in 2016 to $30,354 in 2019 (p = 0.002), but total costs did not change over the same period ($3,993 to $4,708, p = 0.150).
Conclusions :
The predominant demographic of patients receiving care for RRD in the US ED were middle-aged males. There was no evidence of gender selection bias in RRD repair decisions. Hospital charges for RRD repair rose over the four-year study period, and RRD incidence did not show seasonal variation.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.