The relationship between ocular trauma and substance abuse in emergency department patients

Autor: John W Giltner, Richard Lee, Vaama Patel, Catherine A. Marco, Sylvia L. Chang
Rok vydání: 2017
Předmět:
Male
Visual acuity
genetic structures
Ambulances
Poison control
Benzodiazepines
Eye Injuries
0302 clinical medicine
Cocaine
Dronabinol
030212 general & internal medicine
Aged
80 and over
Medical record
Incidence (epidemiology)
Accidents
Traffic
General Medicine
Middle Aged
Analgesics
Opioid
Hospitalization
Substance Abuse Detection
Substance abuse
Emergency Medicine
Female
medicine.symptom
Emergency Service
Hospital
Orbit
Adult
medicine.medical_specialty
Adolescent
Anterior Chamber
Substance-Related Disorders
Violence
Young Adult
03 medical and health sciences
Injury prevention
medicine
Humans
Aged
Ohio
Retrospective Studies
Illicit Substance
Ethanol
business.industry
Air Ambulances
Emergency department
medicine.disease
eye diseases
Surgery
Emergency medicine
030221 ophthalmology & optometry
sense organs
business
Zdroj: The American Journal of Emergency Medicine. 35:1734-1737
ISSN: 0735-6757
DOI: 10.1016/j.ajem.2017.07.015
Popis: Introduction Eye injury is the second most common cause of visual impairment and a leading cause of monocular blindness in the United States. There are approximately 6 million ED visits related to drug use annually, including misuse or abuse of pharmaceuticals and illicit drug use. The purpose of this study was to assess the relationship between ocular trauma and substance abuse among emergency department patients and to assess that relationship with demographic factors, including age and gender. Methods This study was a retrospective, observational study conducted at Miami Valley Hospital, an urban hospital ED, in Dayton, Ohio. Eligible participants included consecutive ocular trauma patients identified by the Trauma Registry from January 2014 through January 2016. Data were collected from the ED medical record including demographic information, mechanism of injury, visual acuity, slit lamp exam findings, ED procedures, inpatient procedures, toxicology results, ED diagnosis, ED disposition, and eye exam. Results Among 229 patients, the mean age was 44 (range 14–93). 73% of patients were male. Most patients were White (74%), followed by African American (21%), Hispanic (2%), and other (3%). Most patients arrived by ambulance (62%), followed by helicopter (30%), and walk-ins (18%). Most patients were admitted to the hospital (79%). Mechanisms of injury included motor vehicle accidents (31%) and cases of assault (28%). Most ocular trauma involved the external eye (44%), the anterior chamber (28%), the orbit (25%) and the globe (22%). The incidence of substance abuse in this patient population was high. Of the patients tested for alcohol (N = 143), 49% tested positive. Among 98 patients who received a urine toxicologic screen, 63% tested positive for at least one illicit substance, including opiates (39%), cocaine (12%), benzodiazepines (25%), and/or THC (27%). There was no significant association between substance abuse and ED disposition. Conclusion Mechanisms of eye injury included primarily motor vehicle accidents and assault. Most ocular trauma involved the external eye, the anterior chamber, the orbit, and the globe. The incidence of alcohol and illicit substance abuse is high among ED patients with ocular trauma.
Databáze: OpenAIRE
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