Abstract
Purpose :
Low socioeconomic status has been associated with a higher incidence of globe injury, which can have devastating effects on vision. Our research aims to examine associations between socioeconomic status (SES), as evaluated by the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) and Distressed Communities Index (DCI), and the incidence and characteristics of open globe injury treated at a Level I trauma center.
Methods :
Retrospective review of electronic medical records from patients that underwent open globe evaluation and repair at Harborview Medical Center between May/2009 and March/2021. Patient recorded data included age, home zip code, date of injury and repair, mechanism of injury, visual acuity (VA) at presentation, concomitant orbital wall fracture, and ocular trauma score (OTS). The SVI and DCI scores were obtained based on the patients' home zip code and county, respectively. Patients were classified based on individual mechanism of injury and grouped into non-accidental vs. accidental cases. Wilcoxon log-rank testing was used for comparing means in continuous variables given the possibility of non-normal data distribution and Pearson chi-square test was used for categorical variables.
Results :
A total of 899 patients were included in our analysis. Average ± SD age (years), SVI, and DCI scores were 44.8 ± 22.7, 0.418 ± 0.207, and 37.9 ±24.0, respectively. Younger age and lower OTS were associated with higher DCI (more disadvantaged) and SVI (more vulnerability) (p<0.001 for all). Non-accidental trauma patients had higher DCI scores compared to accidental trauma patients (p<0.001). Additionally, gunshot injuries were associated with higher SVI and DCI scores (p<0.001 and p=0.040, respectively). Sports-related injuries correlated to a lower DCI score (p=0.009). There were no significant associations with concomitant orbital wall fracture, endophthalmitis, or work-related injury (p≥0.252).
Conclusions :
More disadvantaged SES scores were associated with younger age at time of presentation, non-accidental, and gunshot wound open globe injuries. Understanding the associations between SES and open globe injuries can inform public health strategies, healthcare resource allocation, and targeted interventions to reduce the impact of ocular trauma in communities facing greater economic and social challenges.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.