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National Trends in Imaging Rates for Eye-Related Emergency Department Visits in the United States.

Abstract：

PURPOSE:To identify nationwide trends and factors associated with advanced imaging (computed tomography [CT] and magnetic resonance imaging [MRI]) use for eye-related emergency department (ED) visits. DESIGN:Retrospective, trend study. METHODS:Setting: National Hospital Ambulatory Medical Care Survey 2007-2015. PATIENT POPULATION:Eye-related ED patients who underwent CT or MRI. MAIN OUTCOME MEASURE(S):Population-based CT/MR imaging rates and independent factors associated with imaging. RESULTS:An estimated 7 million eye-related ED visits occurred between 2007 and 2015. Adjusted for annual eye-related ED visits, the rate of imaging use rose 94%, from 121.7 per 1,000 eye-related ED visits in 2007 to 236.0 per 1,000 eye-related ED visits in 2015. Visual disturbances, contusion of the eye and/or adnexa, open globes and open wounds of ocular adnexa, diplopia, superficial corneal and/or conjunctival injuries, and orbital fractures accounted for 73.2% of all visits where imaging was performed. On multivariable analysis, older patients (odds ratio [OR] = 1.02, 95% confidence interval [CI] 1.01-1.03) and females (OR=2.07, 95% CI 1.18-3.63) were more likely to undergo imaging than younger patients and males. Imaging was also more likely to be performed for Medicare beneficiaries (OR=2.12, 95% CI 1.08-4.15) than for privately insured patients. Patients who were admitted to the hospital were 6 times more likely (OR=6.39, 95% CI 2.04-20.0) to undergo imaging than those who were not admitted. CONCLUSIONS:Advanced imaging for eye-related ED visits has escalated at a higher rate than ED visits for eye complaints. Future studies to develop evidence-based algorithms for use of CT/MR imaging for eye complaints that can help balance benefits against financial costs and health risk are warranted.

journal_name

Am J Ophthalmol

journal_title

American journal of ophthalmology

authors

Zafar S,Sebestyen K,Qureshi Z,Schein O,Johnson P,Srikumaran D,Woreta FA

doi

10.1016/j.ajo.2019.11.007

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

114-122

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(19)30544-6

journal_volume

211

pub_type

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National Trends in Imaging Rates for Eye-Related Emergency Department Visits in the United States.