Traumatic Brain Injury in Admitted Patients with Ocular Trauma
Turk J Ophthalmol
; 54(4): 212-222, 2024 08 28.
Article
em En
| MEDLINE
| ID: mdl-39108021
ABSTRACT
Objectives:
To characterize the epidemiology of simultaneous traumatic brain injury (TBI) and ocular trauma. Materials andMethods:
In this retrospective, observational study, de-identified data from patients admitted with ocular trauma and TBI was extracted from the National Trauma Data Bank (2008-2014) using International Classification of Diseases 9th Revision, Clinical Modification diagnostic codes and E-codes relating to injury circumstances. Mechanisms, types of ocular and head injuries, intention, and demographic distribution were determined. Association of variables was calculated with Student's t and chi-squared tests and logistic regression analysis.Results:
Of 316,485 patients admitted with ocular trauma, 184,124 (58.2%) also had TBI. The mean (standard deviation [SD]) age was 41.8 (23) years. Most were males (69.8%). Race/ethnicity distribution was 68.5% white, 13.3% black, and 11.4% Hispanic patients. The mean (SD) Glasgow Coma Score (GCS) was 12.4 (4.4) and Injury Severity Score (ISS) was 17 (10.6). Frequent injuries were orbital fractures (49.3%) and eye/adnexa contusions (38.3%). Common mechanisms were falls (27.7%) and motor vehicle-occupant (22.6%). Firearm-related trauma (5.2%) had the greatest odds of very severe injury (ISS >24) (odds ratio [OR] 4.29; p<0.001) and severe TBI (GCS <8) (OR 5.38; p<0.001). Assault injuries were associated with the greatest odds of mild TBI (OR 1.36; p<0.001) and self-inflicted injuries with severe TBI (OR 8.06; p<0.001). Eye/adnexal contusions were most associated with mild TBI (OR 1.25; p<0.001). Optic nerve/visual pathway injuries had greater odds of severe TBI (OR 2.91; p<0.001) and mortality (OR 2.27; p<0.001) than other injuries. Of associated head injuries, the odds of severe TBI were greatest with skull base fractures (OR 4.07; p<0.001) and mortality with intracerebral hemorrhages (OR 4.28; p<0.001). Mortality occurred in 5.9% of patients.Conclusion:
TBI occurred in nearly two-thirds of ocular trauma admissions. The mortality rate was low with implications for challenging rehabilitation and long-term disability in survivors.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismos Oculares
/
Lesões Encefálicas Traumáticas
Limite:
Adolescent
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Adult
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Aged
/
Child
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article