Frequent attenders to ophthalmic accident and emergency departments

Frequent visitors to the ophthalmology emergency department: Clinical characteristics and management

PURPOSE

To describe the profiles and management patterns of frequent visitors to the ophthalmology emergency department in comparison to patients who visit only occasionally.

METHODS

This study conducted a retrospective analysis spanning a 2.5-year period encompassing all visits to the ophthalmology emergency department. Patients who visited four or more times during this period were identified as frequent users and compared with a control group randomly selected from patients who visited only once. Severity scores associated with diagnoses, ranging from 1 to 5 (Base Score), along with clinical characteristics and patient management strategies, were analyzed using both univariate and multivariate analyses.

RESULTS

Of 18,802 visits, 331 patients (constituting 2.23% of the total) were identified as frequent users during the 2.5-year period, with numbers of visits ranging from 4 to 23. In comparison to the control group, frequent users tended to be approximately 10 years older and presented with more severe diagnoses (Base Score 2.43±1.15 versus 1.89±0.94, P=6.35×10-11). Their visits were predominantly associated with non-traumatic anterior segment pathologies (56% versus 27%) rather than traumatic pathologies (8.7% versus 27%). They were more likely to be referred to senior practitioners within the department (43% versus 33%), necessitated more frequent hospitalizations (33 cases versus 1), and required post-emergency follow-ups or referrals to hyper-specialized consultants.

CONCLUSION

Despite comprising a relatively small percentage of the total patient population, frequent users of ophthalmological emergency departments tend to present with more severe diagnoses. This underscores the importance of optimizing resources to alleviate some of the burden on specialized emergency services.