TY - JOUR
T1 - Lesões oculares relacionadas a armas de fogo
T2 - análise de dados nacionais de traumas nos EUA
AU - Truong, Timothy
AU - He, Catherine Hua
AU - Poulsen, David Michael
AU - Parsikia, Afshin
AU - Mbekeani, Joyce Nanjinga
N1 - Funding Information:
The authors would like to thank John McNelis (MD, FACS, FCCM, MHCM, Chairman, Department of Surgery), Melvin E Stone Jr (MD, Associate Director of Trauma Services & Surgical Critical Care, Department of Surgery), and James Meltzer (MD, Department of Pediatrics) at Jacobi Medical Center (Bronx, NY, USA) for their contributions and support, as well as for providing access to the NTDB database.
Publisher Copyright:
© 2021. This content is licensed under a Creative Commons Attributions 4.0 International License.
PY - 2021
Y1 - 2021
N2 - Purpose: The United States of America has the highest gun ownership rate of all high-income nations, and firearms have been identified as a leading cause of ocular trauma and visual impairment. The purpose of this study was to characterize firearm-associated ocular injury and identify at-risk groups. Methods: Patients admitted with firearm-associated ocular injury were identified from the National Trauma Data Bank (2008–2014) using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes and E-codes for external causes. Statistical analysis was performed using the SPSS 24 software. Significance was set at p<0.05. Results: Of the 235,254 patients, 8,715 (3.7%) admitted with firearm-associated trauma had ocular injuries. Mean (standard deviation) age was 33.8 (16.9) years. Most were males (85.7%), White (46.6%), and from the South (42.9%). Black patients comprised 35% of cases. Common injuries were orbital fractures (38.6%) and open globe injuries (34.7%). Frequent locations of injury were at home (43.8%) and on the street (21.4%). Black patients had the highest risk of experiencing assault (odds ratio [OR]: 9.0; 95% confidence interval [CI]: 8.02–10.11; p<0.001) and street location of injury (OR: 3.05; 95% CI: 2.74–3.39; p<0.001), while White patients had the highest risk of self-inflicted injury (OR: 10.53; 95% CI: 9.39–11.81; p<0.001) and home location of injury (OR: 3.64; 95% CI: 3.33–3.98; p<0.001). There was a steadily increasing risk of self-inflicted injuries with age peaking in those >80 years (OR: 12.01; 95% CI: 7.49–19.23; p<0.001). Mean (standard deviation) Glasgow Coma Scale and injury severity scores were 10 (5.5) and 18.6 (13.0), respectively. Most injuries (53.1%) were classified as severe or very severe injury, 64.6% had traumatic brain injury, and mortality occurred in 16% of cases. Conclusion: Most firearm-associated ocular injuries occurred in young, male, White, and Southern patients. Blacks were disproportionally affected. Most firearm-associated ocular injuries were sight-threatening and associated with traumatic brain injury. The majority survived, with potential long-term disabilities. The demographic differences identified in this study may represent potential targets for prevention.
AB - Purpose: The United States of America has the highest gun ownership rate of all high-income nations, and firearms have been identified as a leading cause of ocular trauma and visual impairment. The purpose of this study was to characterize firearm-associated ocular injury and identify at-risk groups. Methods: Patients admitted with firearm-associated ocular injury were identified from the National Trauma Data Bank (2008–2014) using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes and E-codes for external causes. Statistical analysis was performed using the SPSS 24 software. Significance was set at p<0.05. Results: Of the 235,254 patients, 8,715 (3.7%) admitted with firearm-associated trauma had ocular injuries. Mean (standard deviation) age was 33.8 (16.9) years. Most were males (85.7%), White (46.6%), and from the South (42.9%). Black patients comprised 35% of cases. Common injuries were orbital fractures (38.6%) and open globe injuries (34.7%). Frequent locations of injury were at home (43.8%) and on the street (21.4%). Black patients had the highest risk of experiencing assault (odds ratio [OR]: 9.0; 95% confidence interval [CI]: 8.02–10.11; p<0.001) and street location of injury (OR: 3.05; 95% CI: 2.74–3.39; p<0.001), while White patients had the highest risk of self-inflicted injury (OR: 10.53; 95% CI: 9.39–11.81; p<0.001) and home location of injury (OR: 3.64; 95% CI: 3.33–3.98; p<0.001). There was a steadily increasing risk of self-inflicted injuries with age peaking in those >80 years (OR: 12.01; 95% CI: 7.49–19.23; p<0.001). Mean (standard deviation) Glasgow Coma Scale and injury severity scores were 10 (5.5) and 18.6 (13.0), respectively. Most injuries (53.1%) were classified as severe or very severe injury, 64.6% had traumatic brain injury, and mortality occurred in 16% of cases. Conclusion: Most firearm-associated ocular injuries occurred in young, male, White, and Southern patients. Blacks were disproportionally affected. Most firearm-associated ocular injuries were sight-threatening and associated with traumatic brain injury. The majority survived, with potential long-term disabilities. The demographic differences identified in this study may represent potential targets for prevention.
KW - Database
KW - Eye injuries
KW - Firearms
KW - demographic disparity
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U2 - 10.5935/0004-2749.20210055
DO - 10.5935/0004-2749.20210055
M3 - Article
C2 - 33470343
AN - SCOPUS:85100230544
SN - 0004-2749
VL - 84
SP - 58
EP - 66
JO - Arquivos Brasileiros de Oftalmologia
JF - Arquivos Brasileiros de Oftalmologia
IS - 1
ER -