A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area

<p>Abstract</p> <p>Background</p> <p>To determine the epidemiological characteristics and visual outcome of ocular trauma in southern Italy.</p> <p>Methods</p> <p>All cases of ocular trauma admitted to Department of Ophthalmology of Palermo University, Italy, from January 2001–December 2005 were retrospectively reviewed for open- or closed-globe injury (OGI or CGI). Data extracted included age, sex, residence, initial and final visual acuity (VA), cause and treatment of injury, hospitalization. The injuries were classified by Ocular Trauma Classification System (OTCS) and Birmingham Eye Trauma Terminology (BETT). We also referred to the Ocular Trauma Score (OTS) in evaluating the final visual outcome.</p> <p>Results</p> <p>Of the 298 eyes, there were 146 OGI and 152 CGI. Fifty eyes (16.8%) had an intraocular foreign body (IOFB). The annual incidence of eye injuries was 4.9 per 100,000. Most injuries occurred in men (84.6%, p < 0.0005), with an average age of 33.0 vs. 49.9 for women (p = 0.005). Cause of injury differed significantly by gender (p = 0.001) and urban vs. rural location (p = 0.009). The most frequent causes in men were outdoor activities related injuries (30.9%), work-related (25.4%), and sport-related (17.5%), and in women were home-related (52.2%) and outdoor activities related injuries (30.4%). In urban areas, road accidents were more frequent; in rural areas, work-related injuries were more frequent with a greater rate of IOFBs than in urban areas (p = 0.002).</p> <p>The incidence of OGI and CGI differed in work-related injuries (p < 0.0005), sport-related injuries (p < 0.0005), and assaults (p = 0.033). The final visual acuity was 20/40 (6/12) or better in 144 eyes (48.3%), 20/40–20/200 (6/12–6/60) in 90 eyes (30.2%), and <20/200 (6/60) or less in 46 eyes (15.5%). Eighteen eyes (6%) had a final acuity of no light perception. Of those eyes that presented with hand motion vision or better, 220 (86.6%) had a final vision of better than 20/200 (6/60). Initial visual acuity was found to be correlated with final visual acuity (Spearman's correlation coefficient = 0.658; p < 0.001). The likelihood of the final visual acuities in the OTS categories was correlated to that of the OTS study group in 12 of 14 cases (85.7%).</p> <p>Conclusion</p> <p>This analysis provides insight into the epidemiology of patients hospitalized for ocular trauma. The findings indicate that ocular trauma is a significant cause of visual loss in this population.</p

Morbimortalidade por causas externas na população idosa residente em município da região sul do Brasil Morbimortalidad por causas externas en la población anciana residente en municipio de la región sur de Brasil Morbidity and mortality due to external causes among elders in the south of Brazil

A morbimortalidade por causas externas foi analisada para idosos residentes em Município do Sul do Brasil. Os óbitos, de 1979 a 1998, e as internações, de 1995 a 1998, foram obtidos do Sistema de Informação de Mortalidade, do Sistema de Informações Hospitalares do SUS e a população, dos Anuários do IBGE. O coeficiente de mortalidade por causas externas decresceu 16,2%, mas observaram-se valores crescentes com a idade, maiores no sexo feminino. As quedas, atropelamentos e outros acidentes de transporte foram as causas mais freqüentes. O coeficiente de mortalidade no sexo masculino, no último triênio, foi maior por atropelamentos e no feminino por quedas (64,8 e 58,3 óbitos por 100.000 habitantes, respectivamente). As internações por lesões e envenenamentos decresceram no período e entre as 146 ocorridas em 1998, 45,9% foram por quedas. A comunidade deve reconhecer que o idoso está exposto aos acidentes, sendo necessário que medidas preventivas sejam adotadas.<br>La morbimortalidad por causas externas fue analizada para ancianos residentes en un municipio del sur de Brasil. Los óbitos, de 1979 a 1998 y las internaciones, de 1995 a 1998, fueron obtenidos del Sistema de Información de Mortalidad y del Sistema de Informaciones Hospitalarias del Sistema Único de Salud, y la población, de los Anuarios del Instituto Brasileño de Geografía y Estadística. El riesgo de morir por causas externas decreció 16,2%, pero se observó riesgo creciente con la edad, más evidente en el sexo femenino. Las caídas, atropellamientos y otros accidentes de transporte fueron las causas de óbito más frecuentes. En el último trienio, la mortalidad en el sexo masculino fue mayor por atropellamientos y en el femenino por caídas (64,8 y 58,3 óbitos por 100.000 habitantes, respectivamente) Las internaciones por lesiones y envenenamientos decrecieron en el período y, entre las 146 ocurridas en 1998, el 45,9% fue debido a caídas. La comunidad debe reconocer que el anciano está expuesto a accidentes, siendo necesario que medidas preventivas sean adoptadas.<br>We analyzed morbidity and mortality rates due to external causes among elderly persons in a city in the South of Brazil. Data about deaths, from 1979 to 1998, and about hospital admissions, from 1995 to 1998, were obtained from the Mortality Information System and the Hospital Information System of the Brazilian Ministry of Health. Population data were based on the national demographic census. Mortality rates due to external causes decreased 16.2%, but levels increased in advanced ages, especially for women. Falls, pedestrian accidents and other road accidents were the most important external causes of death in this population. In the last three years of this study, mortality rates were higher for pedestrian accidents among men and for falls among women (64.8 and 58.3 per 100.000 inhabitants, respectively). Hospital admissions due to injuries and intoxications decreased in the period. Among the 146 admissions in 1998, 45.9% were due to falls. The community has to recognize that elderly persons are exposed to accidents and that preventive measures are needed