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Citation
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Zafar S, Sebestyen K, Qureshi Z, Schein O, Johnson P, Srikumaran D, Woreta FA. Am. J. Ophthalmol. 2019; ePub(ePub): ePub. |
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Abstract
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PURPOSE: To identify nationwide trends and factors associated with advanced imaging (computed tomography [CT] and magnetic resonance imaging [MRI]) use for eye-related emergency department (ED) visits.
DESIGN: Retrospective, trend study.
METHODS SETTING: National Hospital Ambulatory Medical Care Survey 2007-2015. PATIENT POPULATION: Eye-related ED visits that underwent CT or MRI imaging. MAIN OUTCOME MEASURE(S): Population-based CT/MRI imaging rates and independent factors associated with imaging.
RESULTS: An estimated 7 million eye-related ED visits occurred between 2007-2015. Adjusted for annual eye-related ED visits, the rate of imaging use rose 94%, from 121.7 per 1000 eye-related ED visits in 2007 to 236.0 per 1000 eye-related ED visits in 2015. Visual disturbances, contusion of the eye and/or adnexa, open globes and open wounds of ocular adnexa, diplopia, superficial corneal and/or conjunctival injuries and orbital fractures accounted for 73.2% of all visits where imaging was performed. On multivariable analysis, older patients (odds ratio (OR)=1.02; 95% confidence interval (CI) 1.01-1.03) and females (OR=2.07; 95% CI 1.18-3.63) were more likely to undergo imaging than younger patients and males. Imaging was also more likely to be performed for Medicare beneficiaries (OR=2.12; 95% CI 1.08-4.15) than for privately-insured patients. Patients who were admitted to the hospital were 6 times more likely (OR=6.39; 95% CI 2.04-20.0) to undergo imaging than those who were not admitted.
CONCLUSIONS: Advanced imaging for eye-related ED visits has escalated at a higher rate than ED visits for eye complaints. Future studies to develop evidence-based algorithms for use of CT/MRI imaging for eye complaints which can help balance benefits against financial costs and health risk are warranted.
Copyright © 2019. Published by Elsevier Inc.
Language: en |