Utilization of Ophthalmic Management in Patients with Head-and-Neck Trauma Secondary to Firearms.

Autor:	De Niear MA; Department of Ophthalmology and Vision Science, University of California Davis Health, Sacramento, CA, USA., Tang VD; Department of Ophthalmology and Vision Science, University of California Davis Health, Sacramento, CA, USA., Nguyen M; Department of Ophthalmology and Vision Science, University of California Davis Health, Sacramento, CA, USA., Lin LK; Department of Ophthalmology and Vision Science, University of California Davis Health, Sacramento, CA, USA.
Jazyk:	angličtina
Zdroj:	Journal of emergencies, trauma, and shock [J Emerg Trauma Shock] 2023 Apr-Jun; Vol. 16 (2), pp. 43-47. Date of Electronic Publication: 2023 May 30.
DOI:	10.4103/jets.jets_165_21
Abstrakt:	Introduction: This retrospective cohort study presents the epidemiology of severe firearm-related ophthalmic injury and the level of ophthalmology involvement in the multidisciplinary management of head-and-neck gunshot injuries. Methods: A retrospective study identified 207 patients with firearm-related injuries involving the head and neck treated at an Academic Tertiary Care Institution from 2010 to 2020. Results: Ophthalmology consulted on 29% of patients with head-and-neck firearm injuries. At least one of the services managing facial trauma (plastic surgery and otolaryngology) consulted on 71.5% of cases ( P < 0.001). Of patients evaluated by ophthalmology, 93.3% survived to discharge; 78.2% of patients who were not evaluated survived to discharge ( P = 0.009). Ophthalmology consulted on all patients with open globe injury (10.6%) ( P < 0.001), all of which were evaluated by the facial trauma service ( P = 0.002), 77.3% by otolaryngology ( P = 0.42), 50% by neurosurgery, 36.4% by plastic surgery, 13.6% by orthopedic surgery, and 4.5% by vascular surgery. Ophthalmology consulted on 76.5% of patients with orbital fracture (32.9%) ( P < 0.001); 83.8% were evaluated by the facial trauma service ( P = 0.006), 69.1% by otolaryngology ( P = 0.014), 54.4% by neurosurgery, 27.9% by plastic surgery, 10.3% by orthopedic surgery, and 2.9% by vascular surgery. For patients with orbital fractures, 92.3% survived when ophthalmology was consulted ( P = 0.698); 43.8% survived when not consulted ( P = 0.001). Conclusions: Firearm-related injuries of the head and neck frequently involve ocular and orbital structures, often causing serious vision-threatening injuries. Multispecialty management is common and early ophthalmology specialist evaluation and co-management are indicated to best identify ophthalmic injuries. Competing Interests: There are no conflicts of interest. (Copyright: © 2023 Journal of Emergencies, Trauma, and Shock.)
Databáze:	MEDLINE
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