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

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.Electronic supplementary materialThe online version of this article (10.1186/s12886-018-1024-7) contains supplementary material, which is available to authorized users.

Characteristics of ocular injuries associated with mortality in patients admitted with major trauma

“…Our study confirmed previously reported findings that firearms and self-inflicted injuries were associated with more severe injury indices and thus mortality [ 19 , 36 , 37 ]. Cut/piece injuries have lower severity indices and lower mortality.…”

“…These children had 8.5 times higher odds of mortality than other intentions. This study found that firearms were the most likely mechanism [ 19 ]. Other trauma investigators have reported similarly high injury severity and mortality rates with self-inflicted trauma than other intentions [ 41 – 43 ].…”

“…TBI was identified based on Center for Disease Control criteria of ICD-9 CM codes for head injuries including extradural hemorrhage, cerebral contusion, base of skull fracture, intracerebral hemorrhage, vault skull fracture, subarachnoid hemorrhage, subdural hemorrhage, and fracture of the facial bone [ 18 ]. Details of the ICD-9 CM codes used are outlined in a previous study [ 19 ].…”

Pediatric Ocular Trauma Management: A Case Study of Effective Intra-Orbital Foreign Body Iofb Extraction

“…The complete removal of residual organic IOFBs is crucial to prevent infections and inflammation. 32 The research describes an uncommon and intriguing case involving a pediatric patient with an intraorbital foreign body (IOFB) that penetrated the orbital cavity and extended into the temporal lobe. Medical terminology is used appropriately, balancing technical details with readability.…”

[Id 57395] Internações E Mortes Por Causas Externas Entre Os Menores De Um Ano, Recife, Pernambuco

“…A morte infantil, em muitos casos, não se deve a uma única causa, mas a uma complexa soma de fatores de risco. A qualidade, a disponibilidade e o acesso aos cuidados em saúde são aspectos importantes que podem influenciar não apenas a probabilidade de sobreviver a uma lesão, mas, também, as consequências em longo prazo [4][5][6] . Programas de prevenção que levam em consideração vulnerabilidades e usam uma abordagem multidisciplinar têm se mostrado os mais eficazes para reduzir a mortalidade infantil como resultado de uma lesão 7 .…”