Risk factors leading to glaucoma surgery of glaucoma patient using Japanese nationwide administrative claims data: A retrospective non-interventional cohort study

Abstract

Background Early recognition and management of baseline risk factors may play an important role in reducing glaucoma surgery burdens. However, no studies have investigated them using real-world data in Japan or other countries. This study aimed to clarify the risk factors leading to glaucoma surgery of glaucoma patient using the Japanese nationwide administrative claims data associated with the diagnosis procedure combination (DPC) system. Methods It was a retrospective, non-interventional cohort study. Data were collected from patients who were admitted to DPC participating hospitals, nationwide acute care hospitals and diagnosed with glaucoma between 2012 to 2018. The primary outcome was the risk factors associated with glaucoma surgery. The association between baseline characteristics and glaucoma surgery was identified using multivariable logistic regression analysis by comparing patients with and without glaucoma surgery. Meanwhile, the secondary outcomes included the rate of comorbidities, the rate of concomitant drug use and the treatment patterns of glaucoma eye drops at the index admission. Among patients with glaucoma surgery, the risk factors leading to cataract surgery were also evaluated as subgroup analysis. Results A total of 29,599 patients included in the analysis, 12,038 and 17,561 patients were in the glaucoma surgery and non-glaucoma surgery cohorts, respectively. The factors associated with the increase in glaucoma surgery were having allergies, taking concomitant drugs including cancer, depression, ischemic heart disease and peptic ulcer, being diagnosed with primary open-angle glaucoma and longer length of stay in hospital. In contrast, the factors associated with the decrease in glaucoma surgery were having hypertension, taking hypertension drug, age ≥ 80 and female. Conclusions Special focus on Japanese patients with glaucoma who have allergy-related comorbidities or take immune, nervous, circulatory or gastrointestinal system-related concomitant drugs seems to be desirable.