National trends in imaging rates for eye-related emergency department visits in the United States

Authors

Sidra Zafar, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Krisztian Sebestyen, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Zaid Qureshi, Aga Khan University
Oliver Schein, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Pamela Johnson, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Divya Srikumaran, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Document Type

Article

Department

Emergency Medicine; Ophthalmology; Surgery

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.

Comments

Issue No. are not provided by the author/publisher

Publication (Name of Journal)

American Journal of Ophthalmology

Recommended Citation

Zafar, S., Sebestyen, K., Qureshi, Z., Schein, O., Johnson, P., Srikumaran, D. (2020). National trends in imaging rates for eye-related emergency department visits in the United States. American Journal of Ophthalmology, 211, 114-122.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_mc/126