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The National Stroke Association and the American Heart Association consider retinal ischemia, as in the case of amaurosis fugax (AF), to be a stroke event. The purpose of this study was to evaluate the risk factors for ischemic cerebral stroke in patients hospitalized for acute AF.The National Inpatient Sample Database from 2002 to 2014 was used to identify patients 21 years of age and older with a primary admission diagnosis of AF with the ICD-9 code 362.34. Comorbidity measures and in-hospital events were extracted using relevant ICD-9 codes. Statistical analyses were performed using IBM SPSS 25 and R package.A weighted total of 12,142 patients was identified. The most common comorbidities in this cohort with AF included hypertension, dyslipidemia, tobacco use, coronary artery disease (CAD), and diabetes mellitus. Multivariable regression analysis showed comorbidities of hypercoagulable state, systemic vasculitis, CAD, and atherosclerosis to be independent risk factors for ischemic stroke in patients with AF. In contrast, dyslipidemia was associated with a decreased risk. Asian/Pacific Islander race conferred a 5-fold increased risk compared with Whites.Ischemic stroke and myocardial infarction were diagnosed in 0.3%-0.9% of hospitalized acute AF cases. Presence of hypercoagulable state, systemic vasculitis, CAD, and atherosclerosis each individually increased the risk of ischemic stroke by more than 3-fold; patients with these risk factors and acute AF should be closely monitored for developing acute systemic thrombotic events. more...

Epidemiologic studies related to the demographics and trends of ocular injury in the pediatric cohort in the last decade are limited. This study describes epidemiologic trends in consumer product–related pediatric ocular injuries from 2010 to 2019. This is a retrospective observational study utilizing data from the National Electronic Injury Surveillance System (NEISS). Inclusion criteria include pediatric patients ages 1–20 presenting to NEISS emergency departments with an ocular injury from January 1, 2010, to December 31, 2019. Outcome measures include prevalence of ocular injury related to consumer products stratified by age group, sex, and injury setting. There were an estimated 636,582 consumer product (CP)–related incidents of ocular injury in children ages 1–20 years with an average age of 9.7 years (SD = 5.92) between 2010 and 2019; 416,378 (65.4%) patients were males with a male-to-female ratio of 1.9:1. The annual incidence of CP-related ocular injury in males decreased from 2010 to 2019 while that in females remained unchanged. The greatest number of injuries occurred in the 1–5-year age group (31%) followed 6–10 group (25%), 16–20 (22%), and 11–15 (21%). Ocular contusion was the most common diagnosis. The most common setting of injury was home (63%). The majority (96%) of patients were treated and released from the ED suggesting a minor injury. Of the 1% of patients admitted to the hospital with ocular injuries, one-fourth were due to an open globe injury. Most ocular injuries occurred in the summer months, and presentation to the ED was more frequent on the weekend than a weekday. Over one-fourth (28%) of injuries were sports-related followed by detergents/chemicals (16%), toys (11%), home workshop equipment (8%), kitchenware (5.0%), and home furniture in (4.4%). The frequency and rate of pediatric ocular injuries in the USA decreased during the last decade. Sports and non-powder guns caused the greatest number of eye injuries in the older pediatric cohorts (11–15- and 16–20-year age groups), while detergents/chemicals accounted for nearly 1/3 of all injuries in younger children (1–5 years). Prophylactic measures targeted to specific age groups will be important in reducing eye injuries further. more...

Purpose To investigate and compare the association of corneal hysteresis (CH) in patients with secondary glaucoma to those with primary open-angle glaucoma (POAG). Additionally, to determine the consistency of CH measurements in patients with secondary glaucoma. Methods A total of 84 patients (121 eyes) were prospectively included in this study. 23 patients (46 eyes) were healthy controls, 24 patients (40 eyes) were diagnosed with POAG, and 27 patients (35 eyes) were diagnosed with a form of secondary glaucoma. CH and intraocular pressure (IOP) were measured using the Ocular Response Analyzer. Three measurements per eye were performed and used for the analysis and to determine fluctuations in CH data. One-way ANOVA with post-hoc Bonferroni analysis and Chi-Squared testing was done to determine differences between groups. Results All patients were matched for age. Patients in both POAG and secondary glaucoma groups were matched for age and IOP. All groups had similar sex and racial compositions as well as similar proportions of diabetes, hypertension, and hyperlipidemia. CH was lower (p 0.05). Conclusion Patients with secondary glaucoma have lower CH when compared to POAG or control groups. The ORA exhibits precision of CH measurements for control, POAG, and secondary glaucoma groups. more...

The purpose of this retrospective, cross-sectional study was to determine and analyze the trends in ocular injuries related to landscaping activities and equipment from 2010 to 2019. A total of 168,845 ocular injuries were associated with landscaping activities with the majority of cases occurring in men (80.4%) between the ages of 41-60 during the summer months of June, July, and August. The majority of ocular injuries did not require admission (97.8%) but of those that were admitted 42% had an open globe injury (n = 399). The results of this investigation provide useful information for emergency room physicians and ophthalmologists in understanding the prevalence of these landscaping-associated ocular injuries and further draw suspicion for the incidence of open globe injuries in this population. more...

The objective of this study is to explore and compare trends in urban and rural cases of endogenous endophthalmitis (EE) in the United States.This study utilizes data from the 2002-2014 National Inpatient Sample (NIS) Database. Disease diagnoses and procedures were identified using codes from theWe identified 8255 cases of EE. Of these cases, 523 (6.3%) occurred in rural areas; 7733 (93.7%) occurred in urban areas. Of the cases of EE, 7692 (93.2%) were bacterial EE, 412 (5.0%) were candida EE, and 151 (1.8%) were mixed EE. Candida EE was observed in 1.7% of rural cases and 5.2% of urban cases (p .001). Pars plana vitrectomies were performed more often in urban hospitals than in rural hospitals (11.5% vs. 2.9%; p .001).Endogenous endophthalmitis remains a rare but devastating ocular infection. In this study, we have demonstrated that there are important differences in cases of EE that present to urban and rural hospitals. Future investigations into these differences in patient demographics, source/systemic infections, and hospital courses may allow clinicians and hospitals to develop a more targeted approach to treating EE based on the type of community from which the patient presents. more...

To identify risk factors for endogenous endophthalmitis (EE) in hospitalized adults, under 65 years of age, with a history of intravenous opioid use and non-ocular infection. The National Inpatient Sample Database was used to identify cases of EE with a recent history of intravenous opioid use disorder with associated non-ocular infection. Systemic and ocular comorbidities were identified using codes from the International Classification of Diseases, Ninth Revision (ICD-9). Descriptive and regression analyses were performed to evaluate the risk factors for EE using IBM SPSS 23. Of the 605,859 inpatients, 21–65 years age, who had a history of recent opioid-IVDU and an associated IVDU-associated systemic infection, 363 (0.1%) had EE. Systemic comorbidities such as diabetes mellitus, mitral valve disease, aortic valve disease, history of cardiac valve transplantation, chronic kidney disease/renal failure, cirrhosis, active or previous radiation therapy, and history of solid organ transplantation were significantly more prevalent in patients with EE. A significantly increased risk of EE in intravenous opioid users was noted if they were of male gender (OR = 1.84), Asian/Pacific Islander ethnicity (OR = 4.41), had history of cirrhosis (OR = 2.33), active or history of radiation therapy (OR = 14.74), history of solid organ transplantation (OR = 5.91), candidemia (OR = 15.22), and infectious endocarditis (OR = 4.83). Conversely, concurrent alcohol use disorder (OR = 0.35) decreased the risk of EE. Various demographic variables and systemic comorbidities increased the risk of developing EE in inpatients with a history of intravenous opioid use with associated non-ocular infection. more...

Purpose: The objective of our project is to use the National Inpatient Sample Database to identify risk factors for endophthalmitis in cases of open-globe injury (OGI). Methods: This is a cross-sectional observational study of 48 627 cases of OGI from the National Inpatient Sample Database. We performed regression analysis using IBM SPSS Statistics 23. Codes from the International Classification of Disease, Ninth Revision were used to identify ocular findings and conditions. Variables with P values less than .05 on univariate analysis were included in the multivariable regression model; Bonferroni correction was applied to these results. Results: Of the 48 627 cases of OGI, 37 440 (77.0%) occurred in the adult group (21 years and older). Overall, 1018 (2.1%) cases developed posttraumatic endophthalmitis, with 74.5% cases in the adult group. Endophthalmitis developed in 293 (4.5%) eyes with an intraocular foreign body (IOFB). Results of binary logistic regression showed the clinical findings of traumatic cataracts, hypopyon, vitreous inflammation, corneal ulcers, or IOFBs were associated with an increased risk of developing endophthalmitis after OGI. Conversely, orbital fractures, rupture-type injuries, and intraocular tissue prolapse were associated with a decreased likelihood of being diagnosed with endophthalmitis. Conclusions: Endophthalmitis developed in 2.4% of pediatric OGIs and 2.0% of adult OGIs. Traumatic cataract, hypopyon, vitreous inflammation, corneal ulcer, keratitis, retinal detachment, IOFB, and diabetes increased the risk of post-open-globe endophthalmitis. more...

Trauma is the leading cause of enucleations in the USA. Current information regarding open globe injuries (OGI) is based mainly on data from individual tertiary care centers across the country which might skew the findings towards the population served by these level-one trauma centers. The aim of this study is to evaluate the demographics, characteristics, and risk factors of traumatic enucleations in a large data sample. Descriptive cross-sectional observational study using the National Inpatient Sample (NIS) Database from 2002 to 2013. Inpatients with traumatic enucleations were identified using ICD-9 codes. Chi-square and logistic regression analyses were used to identify differences between the enucleated and non-enucleated cohorts and to evaluate the predictive factors of enucleation in OGIs. Enucleations were performed in 3020 (6.2%) of 48,563 OGIs identified. The average age in the enucleated cohort for males vs. females was 44.7 vs. 62.2 years. In the USA, the highest number of traumatic enucleations occurred in the 21–40 group (41.8%) and the fewest in the 80+ age group (11.8%). The risk of enucleation decreased across the age groups significantly. Compared with the 21–40 age group, the risk of undergoing enucleation was 15% lower in patients 41 to 60 years of age, 35% in patients 61 to 80, and 40% lower in patients over 80. In total, 5.1% OGIs in women and 6.7% of OGIs in men were enucleated. The risk of enucleation was 29% higher in men than in women. The highest absolute number of enucleations was seen in Whites. Compared with Whites, Blacks had a 63% higher risk of enucleation following an OGI. OGIs with rupture-type injury, endophthalmitis, or phthisis were significantly higher odds to be enucleated. The risk of enucleation following traumatic OGI significantly increased for patients who were in the 21–40 age group, of Black race, or of male gender; the risk also increased if the injury was a rupture-type or associated with endophthalmitis or phthisis. The risk of depression was 75% higher in enucleated patients versus non-enucleated patients. more...

PURPOSE To characterize trends in ocular tennis injuries over the last 20 years. METHODS The National Electronic Injury Surveillance System was utilized to characterize tennis-related eye injuries in a nationally representative sample of emergency department visits. Data were divided into 5 age groups, and various demographic information was obtained. RESULTS Approximately 16,000 tennis-related ocular injuries were identified with males being affected nearly 2:1 compared to females. The youngest age group (0–20) had the greatest proportion of injuries, with most injuries in boys 11–15 years old. Injuries occurred most often during the spring season. Most patients were treated and released from the ED. Of those patients who were hospitalized, one-third had an open globe injury. CONCLUSIONS The overall number of injuries trended downward during the timespan of the study. Although most patients did not experience serious visual consequences, the greatest proportion of ocular tennis injuries occurred in the pediatric age group in whom the risk of amblyopia is high. Primary care providers and tennis regulatory bodies should consider recommending eye safety sports goggles in children to mitigate the potential for significant visual morbidity. more...

To characterize trends in ocular tennis injuries over the last 20 years.The National Electronic Injury Surveillance System was utilized to characterize tennis-related eye injuries in a nationally representative sample of emergency department visits. Data were divided into 5 age groups, and various demographic information was obtained.Approximately 16,000 tennis-related ocular injuries were identified with males being affected nearly 2:1 compared to females. The youngest age group (0-20) had the greatest proportion of injuries, with most injuries in boys 11-15 years old. Injuries occurred most often during the spring season. Most patients were treated and released from the ED. Of those patients who were hospitalized, one-third had an open globe injury.The overall number of injuries trended downward during the timespan of the study. Although most patients did not experience serious visual consequences, the greatest proportion of ocular tennis injuries occurred in the pediatric age group in whom the risk of amblyopia is high. Primary care providers and tennis regulatory bodies should consider recommending eye safety sports goggles in children to mitigate the potential for significant visual morbidity. more...

The popularity of toy guns among children is a growing public health concern due to reports of ocular injury. Most ocular injuries caused by toy guns occur in children younger than 10 years and at home. Dissemination of this information to parents and pediatricians is important to formulate safety measures. [ J Pediatr Ophthalmol Strabismus . 2022;59(3):e29–e31.] more...

Characterize the impact of frailty on endogenous endophthalmitis (EE) development and clinical outcomes among septicemic patients.Population-level, retrospective cohort study.Adult inpatients within the National Inpatient Sample (years 2002-2014) diagnosed with bacterial septicemia.Septicemic patients were classified as frail or nonfrail using the previously validated Johns Hopkins Adjusted Clinical Groups frailty-defining diagnoses indicator, and diagnosis of EE was abstracted from International Classification of Diseases 9 codes. We used multivariable logistic regression to generate odds ratios (ORs) for rates of EE development and in-hospital mortality based on frailty status. We also examined the association between frailty and blood culture-proven organism class, inpatient length of stay, and total charges billed to insurance.Incidence of EE among septicemic patients; rates of EE development among frail and nonfrail patients; blood culture-proven microbe type, length of stay, and total charges billed to insurance.9294 of 18 470 658 (0.05%) inpatients with bacteremia developed EE, 2102 (22.6%) of whom had at least 1 frailty-defining feature (predominantly malnutrition [68%]). Odds of developing EE were 16.7% higher for frail patients (OR, 1.167; 95% confidence interval, 1.108-1.229) when controlling for age, sex, race, concomitant human immunodeficiency virus/AIDS, pyogenic liver abscess, infectious endocarditis, cirrhosis, and diabetes with chronic complications. Frail EE patients had a 27.9% increased odds of in-hospital death, independent of age, sex, race, and Elixhauser comorbidity score (OR, 1.279; 95% confidence interval, 1.056-1.549). Higher rates of methicillin-resistant Staphylococcus aureus bacteremia (14.3% vs. 10.9%, P = 0.000016), gram-negative bacteremia (7.6% vs. 4.9%, P = 0.000003), and concomitant candidemia (10.4% vs. 7.0%, P = 0.0000004) were associated with frailty. Hospital stays were significantly longer (median, 14 days; interquartile range, 19 days; P0.00001) and total charges billed to insurance were significantly greater (median, $96 398; interquartile range, $154,682; P0.00001) among frail EE patients.Frailty syndrome is independently associated with development of EE in the setting of bacterial septicemia; frailty-associated EE may occur in patients with malnutrition and particular bacterial subtypes, and it predisposes to higher rates of in-hospital death and health care resource usage. more...

In a national database, 8.9% of patients with acute open globe injury suffered a concurrent orbital floor fracture, an association significantly impacted by demographics, classification of globe injury, medical history, and status of globe preservation. more...

Currently, there exists a lack of recent epidemiological data concerning ocular injuries due to welding related activities. Our study analyzes trends in ocular injuries related to usage of welding equipment in the U.S. from 2010 to 2019.Using the Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) Database, we queried data from January 1st 2010 to December 31st 2019 using the corresponding product code for welding equipment (896). Results were stratified by year, and standard descriptive statistical methods were applied to components including gender, age, diagnoses, and ED disposition. Circumstances leading up to the injuries were reviewed as well.Between 2010 and 2019 a total of 109,127 welding-associated ocular injuries occurred in the United States (95% CI, 86937-131,316). Estimates show a decreasing trend in cases from 13,415 (95% CI, 9979-16,851) in 2010 to 6944 (95% CI, 4868-9020) in 2019. A majority of cases occurred in men (98.2%) and in the 10-49 year age range (83.8%). 3.3% of cases involved spectators and 44% were bilateral. The top three ocular injury diagnoses were flash burns (62.1%), foreign body implantation (19.6%), and contusions/abrasions (11.1%). The number of radiation injuries trended down from 9286 in 2010 to 4023. With respect to a documented location, 38.9% occurred at home and 4.5% occurred in a school setting. Most patients (99.9%) were discharged from the ED; 0.1% were admitted to the hospital.The data suggests that number of ocular injuries related to welding has decreased significantly over the past 10 years. The most common injuries were radiation burns, foreign body disruption, and contusions/abrasions of the eye. Patients were predominantly men and between the ages of 10 and 49. Of note, almost half of all ocular injuries due to welding were bilateral, and 3% of ocular injuries were seen in spectators. more...

Purpose: To use the National Inpatient Sample (NIS) Database to describe trends in demographics, types, and incidence of pediatric open globe injuries in the United States. Methods: A retrospective, cross-sectional, observational study was conducted of 8,943 acute cases of pediatric open globe injury (age < 21 years) obtained from the NIS Database, between 2002 and 2014. Weighted analysis was performed using IBM SPSS Statistics 25 software (IBM Corporation). Codes from the International Classification of Disease , Ninth Revision, Clinical Modification were used to identify pediatric open globe injury cases. Results: In the United States, 8,943 pediatric cases of acute open globe injuries were identified between 2002 and 2014. Males comprised 78% of the acute pediatric open globe injury cases. Penetrating open globe injuries without intraocular foreign bodies (IOFBs) were the most common type of injury ( P < .001). The proportion of injuries that were penetrating open globe injuries decreased with age, whereas the proportion of IOFBs and globe ruptures increased. The proportion of open globe injuries with IOFB in boys was twice as high as in girls. The incidence of open globe injuries by age, race, and gender was highest in the 16 to 20 years age group, in Blacks and Native Americans, and in boys, respectively. Conclusions: The incidence of open globe injuries in pediatric patients (age < 21 years) was estimated to be 7.93 per 1,000,000 individuals and varied by race, gender, and age. The proportion of different types of open globe injury varied significantly by age, race, and gender. The mean duration of hospital stay for open globe injury management was 2.2 days, and 17.5% of patients lacked medical insurance. [ J Pediatr Ophthalmol Strabismus . 2021;58(4):232–239.] more...

Epidemiologic studies related to the demographics and trends of ocular injury in the pediatric cohort in the last decade are limited. This study describes epidemiologic trends in consumer product-related pediatric ocular injuries from 2010 to 2019.This is a retrospective observational study utilizing data from the National Electronic Injury Surveillance System (NEISS). Inclusion criteria include pediatric patients ages 1-20 presenting to NEISS emergency departments with an ocular injury from January 1, 2010, to December 31, 2019. Outcome measures include prevalence of ocular injury related to consumer products stratified by age group, sex, and injury setting.There were an estimated 636,582 consumer product (CP)-related incidents of ocular injury in children ages 1-20 years with an average age of 9.7 years (SD = 5.92) between 2010 and 2019; 416,378 (65.4%) patients were males with a male-to-female ratio of 1.9:1. The annual incidence of CP-related ocular injury in males decreased from 2010 to 2019 while that in females remained unchanged. The greatest number of injuries occurred in the 1-5-year age group (31%) followed 6-10 group (25%), 16-20 (22%), and 11-15 (21%). Ocular contusion was the most common diagnosis. The most common setting of injury was home (63%). The majority (96%) of patients were treated and released from the ED suggesting a minor injury. Of the 1% of patients admitted to the hospital with ocular injuries, one-fourth were due to an open globe injury. Most ocular injuries occurred in the summer months, and presentation to the ED was more frequent on the weekend than a weekday. Over one-fourth (28%) of injuries were sports-related followed by detergents/chemicals (16%), toys (11%), home workshop equipment (8%), kitchenware (5.0%), and home furniture in (4.4%).The frequency and rate of pediatric ocular injuries in the USA decreased during the last decade. Sports and non-powder guns caused the greatest number of eye injuries in the older pediatric cohorts (11-15- and 16-20-year age groups), while detergents/chemicals accounted for nearly 1/3 of all injuries in younger children (1-5 years). Prophylactic measures targeted to specific age groups will be important in reducing eye injuries further. more...

Autoimmune hepatitis (AIH) is a form of liver inflammation in which immune cells target hepatocytes, inducing chronic inflammatory states. Bariatric surgery (BS) was shown to reduce inflammation in severely obese patients. We hypothesize that obese patients with AIH and BS have lower prevalence of liver-related complications and in-patient mortality compared to those without BS. The National Inpatient Sample from 2007 to 2013 was queried for hospitalizations of adults over 18 years of age with a diagnosis of AIH. Of those, hospitalizations with BS were selected as cases and those with morbid obesity as controls. Case-control 1:2 matching was done based on sex, age, race, and comorbidities. Primary outcomes were prevalence of liver-related complications and in-patient mortality. Independent risk factors of in-patient clinical outcomes were identified using multivariate regression analysis. From 137,834 hospitalizations with a diagnosis of AIH, 688 with BS were selected as cases, and 1295 were matched as controls. The prevalence of ascites was higher in the BS group compared to the control (odds ratio 1.73, 95% confidence interval (CI) 1.27–2.36). The prevalence of cirrhosis (36.8% vs 33.2%), portal hypertension (7.4% vs 10.0%), hepatic encephalopathy (10.6% vs 8.7%), and varices and variceal bleeding (3.9% vs 5.5%) was not statistically different from case controls, (P > .05). BS was an independent risk factor for ascites (adjusted odds ratio (aOR) 1.87; 95% CI 1.36–2.56) and hepatic encephalopathy (aOR 1.42; 95% CI 1.03–1.97) but was an independent protective factor against in-patient mortality (aOR 0.21, 95% CI 0.08–0.55) once adjusted for age, sex, race, and comorbidities. more...

Purpose: Several risk factors have been identified for central retinal vein occlusion (CRVO) in older population. CRVO in young is uncommon, and the risk factors for this group are unclear. This large retrospective, cross-sectional study used the National Inpatient Sample (NIS) database to evaluate the risk factors for CRVO in patients 18 to 40 years of age. Methods: The 2002 to 2014 NIS database was used. All patients 18 to 40 years of age with a primary diagnosis of CRVO were identified. Age- and gender-matched non-CRVO controls were randomly selected. The primary outcome was identification of risk factors for CRVO. Chi-square analysis and Firth logistic regression were performed with IBM SPSS 23 and R packages versions 3.4.3, respectively. p Results: A total of 95 weighted young CRVO patients were identified. The average age was 31.44 ± 6.41 years with no gender predilection. Systemic and ocular conditions found to have statistically significant associations with CRVO included primary open-angle glaucoma (POAG) (OR 836.72, p Conclusion: The most significant risk factors for CRVO in young adults were POAG, retinal vasculitis, and pseudotumor cerebri. Hypercoagulable states and DVT/PE were also associated with CRVO in this population. Systemic inflammatory conditions were not associated with CRVO. Traditional risk factors such as hypertension and diabetes did not pose significant risks, whereas hyperlipidemia was deemed a significant risk factor. more...

To use the 2002 through 2014 National Inpatient Sample (NIS) database to identify risk factors for endogenous endophthalmitis (EE) in hospitalized patients with candidemia.Retrospective, cross-sectional study.Hospitalized patients sampled in the NIS database.The NIS database (2002-2014) was used to identify patients with candidemia and EE and their comorbidities. Descriptive analysis was performed with chi-square testing, and risk factors for EE were identified using logistic regression analysis. Chi-square testing and regression analysis were performed using IBM SPSS software version 23 (IBM Corp, Armonk, NY) and R package software version 3.4.3 (R Foundation for Statistical Computing, Vienna, Austria), respectively.Diagnosis of EE in hospitalized patients with candidemia.We identified 98 783 hospitalized patients with candidemia; 529 patients (0.5%) had concurrent EE. Men constituted 48.0% of patients who did not demonstrate EE and 45.1% of those who did (P = 0.186). The average age of fungemia patients with EE was 54.6 years and of those without EE was 58.2 years (P0.001). Most EE cases (58.6%) occurred in patients 21 to 64 years of age. Hispanic (odds ratio [OR], 1.58), Asian or Pacific Islander (OR, 3.51), and Native American (OR, 5.22) patients with candidemia were at an increased risk of EE developing compared with White patients. Candida endocarditis (OR, 1.84), cirrhosis (OR, 1.93), diabetes with chronic complications (OR, 1.96), intravenous drug use (OR, 3.12), radiation therapy (OR, 5.28), and solid organ transplantation (OR, 2.48) increased the risk of seeding the infection into the eye. Conversely, chronic kidney disease (OR, 0.53) and invasive mechanical intubation (OR, 0.43) were associated with a decreased risk of EE. The mortality of inpatients with candidemia was significantly lower in the EE group (2.8% vs. 15.6%; P0.001).Systemic comorbidities that increased the risk of EE in candidemia included endocarditis, cirrhosis, diabetes with chronic complications, intravenous drug use, radiation therapy, and solid organ transplantation. Racial disparity was observed with Hispanics, Asians and Pacific Islanders, and Native Americans at a higher risk than Whites of being diagnosed with EE in the setting of Candida fungemia. more...

PURPOSE: To evaluate demographic trends of open globe injuries (OGIs) using a large dataset representative of United States population. METHODS: Retrospective cross-sectional observational study using the National Inpatient Sample (NIS) database from 2002 to 2013. Only patients with a primary admitting diagnosis of OGI were included. Data included age (in years), gender, race, type of OGI, death rate and length and cost of stay. RESULTS: During the 12-year period, 27,467 adults (age > 20) with acute OGIs were admitted to the US hospitals. The incidence of OGIs in the adult US population was 10.6 cases per 1,000,000 persons. The mean age was 50.4 years (SD 21.52); the average ages of men and women were 44.34 (SD 17.63) and 65.69 (SD 22.77), respectively. Men accounted for 71% of all cases, with 84% of patients under 60. A decrease in the number of OGIs was seen with advancing age in men, whereas the opposite was true for women. Men, elderly over 80 and Blacks were at the highest risk of sustaining an OGI. The most and least common types of injuries were penetrating injuries (73%) and IOFBs (11%), respectively. Over half of young adults in the 21–40 cohort and 43% of men were uninsured (p more...