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Kodali S, He CH, Patel S, Tao A, Szlechter M, Parsikia A, Mbekeani JN. Characteristics of ocular injuries associated with mortality in patients admitted with major trauma. BMC Ophthalmol 2024; 24:125. [PMID: 38504178 PMCID: PMC10949718 DOI: 10.1186/s12886-024-03392-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Few ocular trauma studies have addressed mortality outcomes. We sought to determine characteristics of mortality-related ocular trauma admissions and compared them with non-fatal injuries. METHODS A retrospective study was conducted using de-identified data of patients admitted with major trauma from the National Trauma Data Bank (2008-2014). Patients with ocular injury were identified using ICD- 9CM codes. Demographics, intention and mechanism, types of ocular and head injuries, and injury severity were documented. Mortality was determined using post-admission disposition. Statistical analysis using student t-test, chi-square, and odds ratios (OR) calculations were performed with STATA-17 software. Significance was set at P < 0.05. RESULTS Of 316,485 patients admitted with ocular trauma, 12,233 (3.86%) were mortality related. Expired patients were older than survivors: mean (SD) of 50.1(25.5) vs. 41.5(22.8) years. White (OR = 1.32; P < 0.001), ≥ 65years old (OR = 2.25; P < 0.001), and male (OR = 1.05; P = 0.029) patients were most likely to expire than their counterparts. Common mechanisms of injury in survivors were falls (25.3%), motor vehicle traffic-occupant, MVTO (21.8%) and struck by/against (18.1%) and for fatal injuries, falls (29.7%), MVTO (21.9%) and firearms (11.5%). Traumatic brain injury (TBI) was documented in 88.2% of mortality-related admissions. Very severe injury severity scores (ISS > 24) (OR = 19.19; P < 0.001) and severe Glasgow Coma Score (GCS < 8) (OR = 19.22; P < 0.001) were most associated with mortality than survival. Firearms were most associated with very severe ISS (OR = 3.73; P < 0.001), severe GCS (OR = 4.68; P < 0.001) and mortality (OR = 5.21; P < 0.001) than other mechanisms. Patients with cut/pierce injuries had the greatest odds of survival (OR = 13.48; P < 0.001). Optic nerve/visual pathways injuries (3.1%) had the highest association with very severe ISS (OR = 2.51; P < 0.001), severe GCS (OR = 3.64; P < 0.001) and mortality (OR = 2.58; P < 0.001) than other ocular injuries. Black patients with very severe ISS (OR = 32.14; P < 0.001) and severe GCS (OR = 31.89; P < 0.001) were more likely to expire than other race/ethnicities with similar injury severity. CONCLUSIONS Mortality-related admissions were older, male, and mostly of White race than ocular trauma admissions of survivors. Firearms were the deadliest mechanism. TBI was commonly associated and patients with optic nerve/pathway injuries, very severe ISS and severe GCS had higher mortality rates. Characteristics and demographic variations identified in this study may be useful in developing focused measures aimed at preventing trauma-related deaths.
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Affiliation(s)
- Sruthi Kodali
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Catherine H He
- Department of Ophthalmology & Visual Sciences, Yale School of Medicine, New Haven, Conn, USA
| | - Sheel Patel
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Alice Tao
- Department of Ophthalmology, Jamaica Hospital Medical Center, New York Medical College, Queens, NY, USA
| | - Moshe Szlechter
- Department of Surgery (Ophthalmology), Jacobi Medical Center, 1400 Pelham Parkway, Bronx, NY, 10461, USA
- Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/ Albert Einstein College of Medicine, Bronx, NY, USA
| | - Afshin Parsikia
- Department of Research Services, University of Pennsylvania, Philadelphia, PA, USA
| | - Joyce N Mbekeani
- Department of Surgery (Ophthalmology), Jacobi Medical Center, 1400 Pelham Parkway, Bronx, NY, 10461, USA.
- Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/ Albert Einstein College of Medicine, Bronx, NY, USA.
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Scanzera AC, Kravets S, Hallak JA, Musick H, Krishnan JA, Chan RP, Kim SJ. Evaluating the Relationship between Neighborhood-Level Social Vulnerability and Patient Adherence to Ophthalmology Appointments. Ophthalmic Epidemiol 2024; 31:11-20. [PMID: 36820490 PMCID: PMC10444903 DOI: 10.1080/09286586.2023.2180806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/28/2023] [Accepted: 02/10/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE To examine the association between neighborhood-level social vulnerability and adherence to scheduled ophthalmology appointments. METHODS In this retrospective cohort study, records of all patients ≥18 years scheduled for an ophthalmology appointment between September 12, 2020, and February 8, 2021, were reviewed. Primary exposure is neighborhood-level Social Vulnerability Index (SVI) based on the patient's residential location. SVI is a rank score of 15 social factors into four themes (socioeconomic status, household composition/disability, minority status/language, and housing type/transportation), ranging from 0 to 1.0, with higher ranks indicating greater social vulnerability. The overall SVI score and each theme were analyzed separately as the primary exposure of interest in multivariable logistic regression models that controlled for age, sex, appointment status (new or established), race, and distance from clinic. The primary outcome, non-adherence, was defined as missing more than 25% of scheduled appointments. RESULTS Of 8,322 patients (41% non-Hispanic Black, 24% Hispanic, 22% non-Hispanic White) with scheduled appointments, 28% were non-adherent. Non-adherence was associated with greater social vulnerability (adjusted odds ratio [aOR] per 0.01 increase in overall SVI = 2.46 [95% confidence interval, 1.99, 3.06]) and each SVI theme (socioeconomic status: aOR = 2.38 [1.94, 2.91]; household composition/disability: aOR = = 1.51 [1.26, 1.81]; minority status/language: aOR = 2.03 [1.55, 2.68]; housing type/transportation: aOR = 1.41 [1.16, 1.73]). CONCLUSION Neighborhood-level social vulnerability is associated with greater risk of non-adherence to scheduled ophthalmology appointments, controlling for individual characteristics. Multi-level intervention strategies that incorporate neighborhood-level vulnerabilities are needed to reduce disparities in access to ophthalmology care.
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Affiliation(s)
- Angelica C. Scanzera
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, 1855 W. Taylor Street, Chicago, IL 60612, United States
| | - Sasha Kravets
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, 1855 W. Taylor Street, Chicago, IL 60612, United States
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, 1603 W. Taylor Street, Chicago, IL 60612, United States
| | - Joelle A. Hallak
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, 1855 W. Taylor Street, Chicago, IL 60612, United States
| | - Hugh Musick
- Institute for Healthcare Delivery Design, Population Health Sciences Program, University of Illinois Chicago, 1220 S. Wood Street, Chicago, IL 60657, United States
| | - Jerry A. Krishnan
- Institute for Healthcare Delivery Design, Population Health Sciences Program, University of Illinois Chicago, 1220 S. Wood Street, Chicago, IL 60657, United States
| | - R.V. Paul Chan
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, 1855 W. Taylor Street, Chicago, IL 60612, United States
| | - Sage J. Kim
- Division of Health Policy & Administration, School of Public Health, University of Illinois Chicago, 1603 W. Taylor Street, Chicago, IL 60612, United States
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Jiro M, Kaidonis G, Chiang J, Stewart J, Padmanabhan S. Firework-Related Ocular Trauma at a Level 1 Trauma Center During a City-Wide Pandemic Lockdown: A Case Series. Cureus 2023; 15:e48531. [PMID: 38073915 PMCID: PMC10704063 DOI: 10.7759/cureus.48531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 02/12/2024] Open
Abstract
Purpose To report six ocular injury cases caused by unlicensed fireworks and subsequent complications at a level 1 trauma center in the setting of coronavirus disease 2019 (COVID-19)-related shelter-in-place orders. Observations All six cases occurred between March 2020 and July 2020 and involved fireworks of non-official use. A majority of subjects were male between the ages of 17 and 53 years old. Ocular trauma presented as the following: Case 1 is a 17-year-old male who sustained a left-sided corneal abrasion and small intraocular foreign body after a firework exploded in his hand. Case 2 is a 47-year-old male who presented with a right globe rupture after being struck with a projectile from a neighborhood fireworks display. Case 3 is a 36-year-old male with corneal abrasion, traumatic iritis, and commotio retinae after a firework injury in the setting of alcohol use. Case 4 is a 35-year-old male who presented with left lid injury, corneal abrasion, and hyphema after being struck by a firework with evidence of penetrating eye trauma on subsequent exams. Case 5 is a 53-year-old male who developed bilateral subconjunctival hemorrhages and a partial-thickness corneal laceration after a firework exploded in his left hand. Case 6 is a 48-year-old woman who sustained bilateral corneal stromal foreign bodies while cooking after a firework exploded near her vicinity. Conclusions and importance Fireworks are a preventable cause of mortality and long-term ocular morbidity. The index of suspicion for open globe injuries related to fireworks should be high given the mechanism of injury. These presenting cases at a level 1 trauma center and safety net hospital may be an unforeseen by-product of COVID-19 lockdowns. Our findings are relevant to trauma centers and safety net hospitals with large cases of firework injuries. Further initiatives to improve awareness of the dangers of fireworks should be prioritized to limit harms for all community members.
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Affiliation(s)
- Marycon Jiro
- School of Medicine, University of California San Francisco, San Francisco, USA
| | - Georgia Kaidonis
- Department of Ophthalmology, West Coast Retina Medical Group, San Francisco, USA
| | - Joey Chiang
- Department of Medicine, University of Washington, Seattle, USA
| | - Jay Stewart
- Department of Ophthalmology, University of California San Francisco, San Francisco, USA
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Daniel AD, Achar S, Parikh M. Blunt Ocular Trauma in Sport. Curr Sports Med Rep 2023; 22:375-379. [PMID: 37921390 DOI: 10.1249/jsr.0000000000001116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Affiliation(s)
| | - Suraj Achar
- University of California, San Diego Health System, San Diego, CA
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Frolli A, Cerciello F, Esposito C, Russo M, Bisogni F. Learning Italian as a Second Language in a Sample of Ukrainian Children: A Game-Based Learning Approach. Pediatr Rep 2023; 15:502-511. [PMID: 37606450 PMCID: PMC10443373 DOI: 10.3390/pediatric15030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
Game-based learning is an educational approach aimed at acquiring knowledge through the use of play. There are various studies that note the effectiveness of playing as an educational tool and the use of digital platforms as a tool that can increase its effectiveness. We wanted to investigate whether a game-based learning approach may determine an improvement in Italian as a foreign language in terms of vocabulary expansion. The sample consists of 48 Ukrainian children between 6 and 7 years old. There were 24 female children and 24 male children in the sample, divided into two groups: the control group (Gr1) learnt Italian through frontal lessons (traditional approach), the experimental group (Gr2) learnt Italian through games and activities (game-based learning). The results have shown that the experimental group had a major increase in Italian vocabulary. However, both groups had an increase in this sense. Game-based learning remains an effective and promising educational approach, but other variables must be taken into account. Furthermore, the scarcity of literature on foreign language learning through game-based learning creates the need for more studies.
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Affiliation(s)
- Alessandro Frolli
- Disability Research, Centre of Rome University of International Studies, 00147 Rome, Italy; (F.C.); (C.E.); (M.R.); (F.B.)
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Munir SZ, Munir WM. Association Between Socioeconomic Deprivation and Orbital Trauma in a Hospital-Based Population. Ophthalmic Epidemiol 2023:1-10. [PMID: 37332246 DOI: 10.1080/09286586.2023.2225590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 05/30/2023] [Accepted: 06/11/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE To examine the association between area-level socioeconomic deprivation and orbital trauma among emergency ophthalmology consults. METHODS We conducted a cross-sectional study using 5-year Epic data for all hospital-based ophthalmology consults at the University of Maryland Medical System, and the Distressed Communities Index (DCI) data for area-level socioeconomic deprivation. We ran multivariable logistic regression models adjusting for age to compute odds ratios (OR) and 95% confidence intervals (CI) for the association between the DCI quintile 5 distressed score and orbital trauma. RESULTS A total of 3,811 cases of acute emergency consults were identified, of whom 750 (19.7%) had orbital trauma and 2,386 (62.6%) had other traumatic ocular emergencies. The odds of orbital trauma among people living in a distressed community were 0.59 (95% CI 0.46-0.76) times the odds for those living in a prosperous community. Among White subjects, the odds of orbital trauma for people living in a distressed community were 1.71 (95% CI 1.12-2.62) times the odds for those living in a prosperous community; among Black subjects, the OR was 0.47 (95% CI 0.30-0.75; p-interaction = 0.0001). Among women, the OR for orbital trauma among those living in a distressed community was 0.46 (95% CI 0.29-0.71); among men, the OR was 0.70 (95% CI 0.52-0.97; p-interaction = 0.03). CONCLUSION Overall, we found an inverse association between higher area-level socioeconomic deprivation and orbital trauma among both men and women. The association varied by race, such that there was an inverse association with higher deprivation among Black subjects in contrast to a positive association among White subjects.
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Affiliation(s)
- Saleha Z Munir
- Department of Ophthalmology & Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Wuqaas M Munir
- Department of Ophthalmology & Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
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Cro S, Partington G, Cornelius VR, Banerjee PJ, Zvobgo TM, Casswell EJ, Shahid S, Bunce C, Robertson E, Murphy C, Kelly J, Charteris DG. Presenting clinical characteristics of open globe injuries in ocular trauma: baseline analysis of cases in the ASCOT national clinical trial. Eye (Lond) 2023; 37:1732-1740. [PMID: 36104523 PMCID: PMC10220025 DOI: 10.1038/s41433-022-02206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 06/30/2022] [Accepted: 08/10/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES The Adjunctive Steroid Combination in Ocular Trauma (ASCOT) trial is a unique pragmatic, multi-centre, patient and assessor masked, randomised controlled trial. We evaluate the clinical characteristics and pathology of this large trial cohort of patients with open globe injuries undergoing vitreoretinal surgery, including the associations between patient characteristics and their baseline vision. SUBJECTS/METHODS We (i) summarise demographics, injury history and ocular history of the 280 participants recruited into the ASCOT trial using descriptive statistics; (ii) analyse the national and seasonal variation across England and Scotland in these participant characteristics; and (iii) explore the associations between participant demographic, trauma history, ocular history and presenting baseline visual acuity (measured using the Early Treatment Diabetic Retinopathy Study, ETDRS) using multivariable regression analyses. RESULTS The majority of participants with open globe penetrating injuries were of white ethnicity (233, 84%), male (246, 88%), with a median age of 43 years (IQR 30-55 years). There was considerable variability in presenting visual acuity with 75% unable to read any letters on the ETDRS chart, whilst the median ETDRS letter score was 58 (IQR 24-80) for those who could read ≥1 letter. The most common causes of injury were workplace related (31%) or interpersonal violence (24%). Previous eye surgery, visual axis corneal scar, lens status, hyphaemia and vitreous haemorrhaging were found to be associated with presenting vision as measured by the ETDRS chart. CONCLUSION The ASCOT trial provides valuable insights into the spectrum of pathology of patients with open globe eye injuries undergoing vitreoretinal surgery. The identified causes of injury and clinical presentation of the cases will help in training and resource planning to deal with these often challenging surgical cases. TRIAL REGISTRATION EudraCT No. 014-002193-37. HTA Project 12/35/64.
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Affiliation(s)
- Suzie Cro
- Imperial Clinical Trials Unit, Imperial College London, London, UK.
| | - Giles Partington
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | | | | | | | | | - Syed Shahid
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Catey Bunce
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Caroline Murphy
- King's Clinical Trials Unit at Kings Health Partners, King's College London, London, UK
| | - Joanna Kelly
- King's Clinical Trials Unit at Kings Health Partners, King's College London, London, UK
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Lacey Q. Impact of the Social Determinants of Health on Adult Trauma Outcomes. Crit Care Nurs Clin North Am 2023; 35:223-233. [PMID: 37127378 DOI: 10.1016/j.cnc.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Social determinants of health (SDOHs) have been well studied within the literature in the United States but the effects of these determinants of health on patients with trauma have garnered less attention. The interaction between patients with SDOHs and patients with trauma requires clinicians caring for this population to view patients with trauma through a multifaceted lens. The purpose of this article will be to illuminate the drivers of trauma in the adult population and how the SDOHs and the health-care system come together to contribute to disparities in trauma outcomes.
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Zhang J, Liang X, Su T, Li X, Ge J, An Z, Xu Y. The mediating effect of geospatial thinking on the relationship between family capital and sense of place. Front Psychol 2022; 13:918326. [DOI: 10.3389/fpsyg.2022.918326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022] Open
Abstract
Few studies have examined how family capital affects the sense of place, and the effect of spatial thinking on the relationship between the two is unclear. This study constructs a mediation model to examine the impact of family capital on sense of place and the mediation effect of geospatial thinking. A total of 1,004 upper-secondary-school students were surveyed using the Family Capital Questionnaire, the Geospatial Thinking Test, and the Sense of Place Scale. The correlation analysis showed that family capital has a positive effect on both sense of place and geospatial thinking. Moreover, there is also a significant positive correlation between geospatial thinking and sense of place. The results of mediation analysis indicated that geospatial thinking plays mediating and buffering roles in the relationship between family capital and sense of place after controlling for gender and residential address. The direct and indirect effects accounted for 73.31 and 26.69% of the total effect, respectively. Specifically, family capital is a significant positive predictor of both sense of place and geospatial thinking, and geospatial thinking partially mediates the relationship between family capital and sense of place. Students from better family backgrounds are more likely to have a better geospatial thinking and sense of place, as well as geospatial thinking promotes the development of a sense of place. Therefore, both family capital and geospatial thinking should be considered when we want to examine and develop individuals’ level of sense of place.
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Kousiouris P, Gouliopoulos N, Kourtesa A, Dimtsas GS, Chatzistefanou K, Bouratzis N, Kantzanou M, Moschos MM. The Demographic and Social Characteristics of Patients with Ocular Foreign Bodies in a Greek Tertiary Hospital. Clin Ophthalmol 2022; 16:2323-2328. [PMID: 35915588 PMCID: PMC9338389 DOI: 10.2147/opth.s370188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Patients and Methods Results Conclusion
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Affiliation(s)
- Panagiotis Kousiouris
- 1st Department of Ophthalmology, University of Athens Medical School, G. Gennimatas Hospital, Athens, Greece
| | - Nikolaos Gouliopoulos
- 2nd Department of Ophthalmology, University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - Anastasia Kourtesa
- 1st Department of Ophthalmology, University of Athens Medical School, G. Gennimatas Hospital, Athens, Greece
| | - Georgios S Dimtsas
- 1st Department of Ophthalmology, University of Athens Medical School, G. Gennimatas Hospital, Athens, Greece
| | - Klio Chatzistefanou
- 1st Department of Ophthalmology, University of Athens Medical School, G. Gennimatas Hospital, Athens, Greece
| | - Nikolaos Bouratzis
- 2nd Department of Ophthalmology, University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - Maria Kantzanou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Marilita M Moschos
- 1st Department of Ophthalmology, University of Athens Medical School, G. Gennimatas Hospital, Athens, Greece
- Correspondence: Marilita M Moschos, 1st Department of Ophthalmology, University of Athens Medical School, G. Gennimatas Hospital, 154 Leof. Mesogeion, Athens, 115 27, Greece, Tel +30 6944887319, Email
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