Disability-Adjusted Life Years Resulting from Ocular Injury among Deployed Service Members, 2001-2020.

Autor:	Travor MD; Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire., Levine ES; Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire., Catomeris AJ; Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire., Purt B; Walter Reed-Uniformed Services University Department of Surgery, Uniformed Services University, Bethesda, Maryland; Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan., Gensheimer WG; Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Ophthalmology Section, White River Junction VA Medical Center, White River Junction, Vermont., Justin GA; Walter Reed-Uniformed Services University Department of Surgery, Uniformed Services University, Bethesda, Maryland., Trevino JD; Department of Data Analytics and Epidemiology, The Geneva Foundation, JBSA Fort Sam Houston, San Antonio, Texas., Haagsma JA; Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands., Colyer MH; Walter Reed-Uniformed Services University Department of Surgery, Uniformed Services University, Bethesda, Maryland., Staudt AM; Department of Data Analytics and Epidemiology, The Geneva Foundation, JBSA Fort Sam Houston, San Antonio, Texas. Electronic address: astaudt@genevausa.org.
Jazyk:	angličtina
Zdroj:	Ophthalmology [Ophthalmology] 2024 May; Vol. 131 (5), pp. 534-544. Date of Electronic Publication: 2023 Nov 24.
DOI:	10.1016/j.ophtha.2023.11.023
Abstrakt:	Purpose: To quantify the burden of ocular injuries on deployed US service members by calculating disability-adjusted life years (DALYs). Design: Retrospective, observational cohort study. Participants: US service members with ocular injuries sustained in combat zones from January 1, 2001 to May 19, 2020. Methods: Health states and duration of injuries were identified using data from the Defense and Veterans Eye Injury and Vision Registry. These health states were mapped to disability weights from the Global Burden of Disease (GBD) study. Average duration of injury or illness was calculated until remission or death. For the latter, life expectancy at age of sustaining injury, as identified from US Life Tables from the National Vital Statistics Reports 2020, was used. Using Defense Manpower Data Center reports capturing number of service members deployed per year, incidence rates were calculated for ocular injury and DALYs. Main Outcome Measures: Disability-adjusted life years of ocular injury. Results: Seventeen thousand five hundred fifty-five patients sustained ocular injury that incurred DALYs. In total, these injuries resulted in 11 214 DALYs (average, 0.64 DALYs per included patient and 20.6 DALYs per 10 000 US service members per year). Severe impairment of distance vision (77.9%) and blindness (10.6%) were the primary contributors of DALYs. Although only 9.3% of patients sustained a permanent ocular injury, permanent disability accounted for 99.5% of total DALYs. The average yearly incidence rate of ocular injury was 32.0 cases per 10 000 US service members. Foreign body was the most frequent injury type (2754 occurrences), followed by abrasion (2419 occurrences) and multiple injury types (1429 occurrences). The most DALYs occurred in patients with multiple injury types (2485 DALYs), followed by abrasion (accounting for 725 DALYs) and foreign body (accounting for 461 DALYs). Discussion: We report higher average DALYs per case ratio among US service members compared with the general population studied by the GBD study, highlighting the differences in probabilities of permanent injury between the two studies. Our study provides understanding of the impact of ocular injuries on active-duty service members and lays the groundwork for further research and interventions to mitigate their burden. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. (Copyright © 2023 American Academy of Ophthalmology. All rights reserved.)
Databáze:	MEDLINE
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