目的:确定当日出院的动态眼眶骨折修复术后30天急诊室(ER)就诊率,以及与ER访视相关的原因和危险因素。
方法:数据库研究。
方法:加利福尼亚州门诊手术和服务数据库(SASD)和州急诊室数据库(SEDD),纽约,2011年佛罗里达
方法:我们确定了SASD成人的眼眶骨折修复程序,与SEDD相关,以确定30天内ER访视的发生率和原因。使用单变量和多变量逻辑回归模型来确定与ER访问相关的因素。
结果:在762名患者中,术后30天的ER访视率为4.5%.大多数ER访视(58.9%)发生在手术后的第一周。急诊就诊最常见的原因与疼痛有关,肿胀,头痛,头晕,和疲劳(29.4%),其次是眼科病因,包括视力障碍和眼部感染(14.7%).无一例球后血肿。在多变量分析中,与加利福尼亚州相比,居住在佛罗里达州的患者进行ER就诊的风险明显更高(比值比:4.48[1.43-14.10],p=.010)。
结论:动态眼眶骨折修复似乎是安全的。急诊就诊的常见原因包括疼痛,肿胀,和眼科症状。某些地理区域的ER访视风险增加,但医疗合并症或并发面部骨折或手术没有。
OBJECTIVE: To determine the 30-day postoperative emergency room (ER) visit rate following ambulatory orbital fracture repair with same-day discharge, and the causes and risk factors associated with ER visit.
METHODS: Database study.
METHODS: State Ambulatory Surgery and Services Database (SASD) and State Emergency Department Database (SEDD) for California, New York, and Florida for 2011.
METHODS: We identified orbital fracture repair procedures among adults from the SASD, which was linked to the SEDD to identify the incidence and causes of ER visits within 30 days. Univariate and multivariable logistic regression models were used to determine the factors associated with ER visit.
RESULTS: Among 762 patients, the 30-day postoperative ER visit rate was 4.5%. Most ER visits (58.9%) occurred during the first week after surgery. The most common reasons for ER visits were related to pain, swelling, headache, dizziness, and fatigue (29.4%), followed by ophthalmologic etiologies including visual disturbances and infection of the eye (14.7%). There was no case of retrobulbar hematoma. In the multivariate analysis, patients living in Florida were at a significantly higher risk for ER visit compared to those in California (odds ratio: 4.48 [1.43-14.10], p = .010).
CONCLUSIONS: Ambulatory orbital fracture repair appears to be safe. Common reasons for ER visit included pain, swelling, and ophthalmic symptoms. An increased risk for ER visit was seen with certain geographic regions but not with medical comorbidities or concurrent facial fractures or procedures.