A comparison of pediatric ocular injuries based on intention in patients admitted with trauma

Ryan Gise,Joyce N Mbekeani,Afshin Parsikia,Timothy Truong

doi:10.1186/s12886-018-1024-7

Ryan Gise, Joyce N Mbekeani + Show 2 more

Open Access

https://doi.org/10.1186/s12886-018-1024-7

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Abstract

PurposePediatric ocular trauma is a major source of morbidity and blindness and the number of epidemiological studies is incommensurate with its significance. We sought to determine differences in epidemiologic patterns of pediatric ocular injuries based on intention.MethodsA retrospective review of the National Trauma Data Bank (2008–2014) was performed and patients < 21 years old, admitted with trauma and ocular injury, were identified using ICD-9CM codes. Demographic data, types of injury and external circumstances including intention were tabulated and analyzed with students’ t and chi-squared tests and logistic regression. Statistical significance was set at p < 0.05.ResultsFifty-eight thousand seven hundred sixty-five pediatric patients were admitted for trauma and ocular injuries. The mean(SD) age was 11.9(6.9) years. Most patients were male (68.7%) and White (59.1%). Unintentional injuries (76.3%) were mostly associated with falls (OR = 13.4, p < 0.001), assault (16.3%) with firearms (OR = 9.15, p < 0.001) and self-inflicted trauma (0.7%) also with firearms (OR = 44.66, p < 0.001). There was increasing mean(SD) age from unintentional, 12.9(6.6) years and assault 12.3(8.1) years to self-inflicted trauma, 17(3.4) years. The 0-3 year age group had highest odds of open adnexa wounds (OR = 30.45, p < 0.001) from unintentional trauma, and traumatic brain injury (TBI) (OR = 5.77, p < 0.001) and mortality (OR = 8.52, p < 0.001) from assault. The oldest 19-21 year group, had highest odds visual pathway injuries (OR = 8.34, p < 0.001) and TBI (OR = 1.54, p = 0.048) from self-inflicted trauma and mortality (OR = 2.08, p < 0.001) from unintentional trauma.ConclusionSight-threatening injuries were mostly associated with unintentional trauma in the youngest group and self-inflicted trauma in the oldest group. Patterns emerged of associations between demographic groups, mechanisms, types of injury and associated TBI with intention of trauma.

Highlights

Pediatric trauma, from both accidental and intentional causes, is a leading cause of morbidity and mortality [1, 2]
We used a large national database to evaluate pediatric ophthalmic injuries in patients admitted for trauma in order to elucidate if specific patterns of injuries based on intention exist
Characteristics of pediatric ocular trauma from all intentions During the study period (2008–2014), 58,765 pediatric patients were admitted for trauma and had concomitant ocular injuries with a mean age (SD) of 11.9(6.9) years

Summary

Introduction

From both accidental and intentional causes, is a leading cause of morbidity and mortality [1, 2]. Epidemiology and investigations into diagnostic accuracy of ocular findings in Non-Accidental Trauma (NAT) remain active areas of research [11,12,13]. While retinal findings in NAT are widely reported, there are limited studies of other ophthalmic injuries resulting from assault [15]. Several studies have investivated the epidemiology of assault in children, comparing resulting injuries to unintentional trauma, to identify disparate patterns [1, 3, 16,17,18,19]. We used a large national database to evaluate pediatric ophthalmic injuries in patients admitted for trauma in order to elucidate if specific patterns of injuries based on intention exist

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Discussion

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