Epidemiology of ophthalmic trauma in the United States from 2009-2018: A Nationwide Emergency Department Sample Analysis

Mustafa Iftikhar; Joseph K Canner; Asad Latif; Syed M A Shah; Grant A Justin; Fasika A Woreta

doi:10.1016/j.injury.2023.111209

Epidemiology of ophthalmic trauma in the United States from 2009-2018: A Nationwide Emergency Department Sample Analysis

Injury. 2024 Mar;55(3):111209. doi: 10.1016/j.injury.2023.111209. Epub 2023 Nov 17.

Authors

Mustafa Iftikhar¹, Joseph K Canner², Asad Latif³, Syed M A Shah¹, Grant A Justin⁴, Fasika A Woreta⁵

Affiliations

¹ Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
³ Johns Hopkins Surgery Center for Outcomes Research, Johns Hopkins School of Medicine, Baltimore, MD, USA.
⁴ Walter Reed National Military Medical Center, Bethesda, MD, USA.
⁵ Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: fworeta1@jhmi.edu.

PMID: 38012902
DOI: 10.1016/j.injury.2023.111209

Abstract

Purpose: To determine the incidence, characteristics, disposition, and economic burden of emergency department (ED) visits for ophthalmic trauma in the United States (US).

Design: Retrospective study.

Methods: The Nationwide Emergency Department Sample was used to calculate and characterize ED visits for ophthalmic trauma in the US from 2009 to 2018. Linear regression was used to estimate trends in annual incidence and mean inflation-adjusted ED charges. Logistic regression was used to assess variables associated with inpatient admission.

Results: There were over 7.3 million ED visits for ophthalmic trauma in the US over the 10 years, with an annual incidence of 233 per 100,000 population. Patients were predominantly male (65 %), 21-44 years old (39 %), and from low-income households (56 %). Only 1 % of patients were hospitalized. Older age, male sex, metropolitan teaching hospitals, and trauma centers were associated with significantly higher odds of inpatient admission. The mean inflation-adjusted ED charge per visit more than doubled over the decade ($1,333 to $3,187) with total charges exceeding $14 billion. Superficial injuries (44 %) and eyelid/orbit wounds (20 %) accounted for the majority of visits. Orbital floor fractures (4 %) and open globe injuries (2 %) accounted for a minority of visits but were responsible for most admissions (49 % and 29 %, respectively) and the highest mean ED charge ($7,157 and $6,808, respectively).

Conclusions: Ophthalmic trauma represents an increasingly significant burden to EDs in the US. Preventive efforts should target young males from low socioeconomic backgrounds. Strategies to improve outpatient access and redirect non-urgent injuries may help alleviate costs.

Keywords: Emergency department; Emergency room; Epidemiology; Eye injuries; Eye trauma; Ocular trauma; Ophthalmic trauma; United States.

MeSH terms

Adult
Emergency Service, Hospital*
Eye Injuries* / epidemiology
Eye Injuries* / therapy
Female
Hospitalization
Humans
Male
Retrospective Studies
Trauma Centers
United States / epidemiology
Young Adult