Purpose: 

To characterize demographics and trends in oculoplastics-related emergency department (ED) visits.

Methods: 

The authors conducted a retrospective, multiyear study of the nationwide ED sample database. The nationwide ED sample was queried for oculoplastics-related International Classification of Disease-ninth revision codes identified from a comprehensive list and categorized based on anatomic location, urgency, and trauma status. Demographics, clinical characteristics, procedure requirement, and cost data were analyzed. Variables associated with inpatient admission were assessed using univariate and multivariate logistic regression.

Results: 

The authors identified an estimated 4.2 million ED visits in the United States with oculoplastics-related primary diagnoses, of which pathology was 80.8% eyelid/adnexal, 17.4% orbital, and 1.74% lacrimal. Overall, 31.3% of the visits were deemed to be nonurgent. Orbital pathology was more likely to be caused by trauma (70.6%), to be urgent (98.0%), and to require a procedure (45.6%) (p < 0.001). While less than 5% of all patients required hospitalization, predictors for inpatient admission were urgent diagnoses (odds ratio, 14.9; CI, 13.7–16.1), presentation to a level 1 trauma center (odds ratio, 3.19; CI, 2.7–3.79), and presence of orbital pathology (odds ratio, 6.09; CI 5.73–6.47). Incidence of ED visits decreased in all categories; however, total inflation-adjusted charges increased.

Conclusions: 

Over half of oculoplastics-related ED visits are for trauma, with orbital pathology being less common but requiring a high level of care. Although trends show a potentially decreasing incidence of oculoplastics-related ED visits, increasing costs and high proportion of nonurgent visits pose an opportunity for mitigating periocular trauma and increasing outpatient access to care, respectively.

中文翻译：

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2006-2015 年美国眼整形相关急诊就诊的流行病学趋势

目的： 

描述与眼整形相关的急诊科 (ED) 就诊的人口统计特征和趋势。

方法： 

作者对全国 ED 样本数据库进行了多年的回顾性研究。对全国急诊室样本进行了查询，以查找与眼整形相关的国际疾病分类第九版修订代码，该代码是从综合列表中确定的，并根据解剖位置、紧急程度和创伤状态进行分类。分析了人口统计、临床特征、手术要求和成本数据。使用单变量和多变量逻辑回归评估与住院患者入院相关的变量。

结果： 

作者发现，在美国，估计有 420 万急诊就诊者患有眼整形相关的初步诊断，其中 80.8% 为眼睑/附件，17.4% 为眼眶，1.74% 为泪道。总体而言，31.3% 的访问被认为是非紧急的。眼眶病变更有可能是由外伤（70.6%）、紧急（98.0%）和需要手术（45.6%）引起（p < 0.001）。虽然不到 5% 的患者需要住院治疗，但住院的预测因素是紧急诊断（优势比，14.9；CI，13.7-16.1）、前往 1 级创伤中心就诊（优势比，3.19；CI，2.7-3.79） ，以及眼眶病变的存在（比值比，6.09；CI 5.73–6.47）。所有类别的急诊就诊率均有所下降；然而，经通货膨胀调整后的总费用有所增加。

结论： 

超过一半的眼整形相关急诊就诊是因为外伤，眼眶病变不太常见，但需要高水平的护理。尽管趋势显示与眼整形相关的急诊就诊的发生率可能会下降，但不断增加的费用和高比例的非紧急就诊分别为减轻眼周创伤和增加门诊患者获得护理的机会提供了机会。