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Corneal and conjunctival injury seen in urgent care centres in Israel
Author(s) -
Zimmerman Deena R,
Shneor Einat,
Millodot Michel,
GordonShaag Ariela
Publication year - 2019
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1111/opo.12600
Subject(s) - medicine , emergency department , medical record , logistic regression , demographics , descriptive statistics , diagnosis code , pediatrics , family medicine , medical emergency , emergency medicine , demography , surgery , population , statistics , mathematics , environmental health , psychiatry , sociology
Purpose Corneal and conjunctival injuries ( CCI ) comprise a large portion of the cases presenting to hospital‐based emergency departments ( ED ) with ocular involvement. Urgent Care Centres ( UCC ) offer community based emergency care at lower cost than hospital‐based emergency departments ( ED ) and with greater temporal convenience than primary care office settings. While CCI prevalence and treatment at hospital‐based ED s has been well studied, this is the first report, to our knowledge, on CCI demographics and aetiology presenting to UCC s. Methods This retrospective study was approved by the institutional ethics committee. The setting is a UCC system in Israel, modelled on USA urgent care facilities, consisting of 17 branches at the time of the study. Electronic medical record data (between November 1, 2015 and October 31, 2016) of patients diagnosed with corneal disorder, foreign body or eye disorder were retrieved and reviewed for inclusion/exclusion criteria. Data collected included gender, age, chief complaint, diagnosis, treatment and discharge status (sent home or referred to ED ). International Classification of Diseases, Ninth Revision ( ICD ‐9) codes were assigned to each record based on a review of all fields. UCC results were compared to all ED patients in Israel using data from a public report. Data were analysed by descriptive statistics and logistic regression analysis. Results Of the 602 074 charts screened, 4797 patients presented with CCI (0.8%). The average age was 32.6 ± 18.2 years and 71.3% were male. Among these, 26.4% were referred to the ED compared to 6.8% from the entire UCC cohort. ICD ‐9 code Foreign body ( FB ) of the eye was the most common cause of CCI (56.5%) followed by the following ICD ‐9 codes: trauma (18.1%), chemical in the eye (11.1%) and corneal disorder due to a contact lens (5.1%). Logistic regression analyses showed the following risk factors for ED referral: age (22–64), male gender, ICD ‐9 code FB , work‐related injury and the presence of a clinical abrasion in the eye. Conclusions The aetiology of ocular injury at UCC is similar to previous studies of ED . Most CCI can be treated at UCC saving ED resources and underscores the importance of this mode of health care delivery in the overall health system.