A comparison of pediatric ocular injuries based on intention in patients admitted with trauma

Pediatric ocular trauma is a major source of morbidity and blindness and the number of epidemiological studies is incommensurate with its significance. We sought to determine differences in epidemiologic patterns of pediatric ocular injuries based on intention.

A retrospective review of the National Trauma Data Bank (2008-2014) was performed and patients < 21 years old, admitted with trauma and ocular injury, were identified using ICD-9CM codes. Demographic data, types of injury and external circumstances including intention were tabulated and analyzed with students' t and chi-squared tests and logistic regression. Statistical significance was set at p < 0.05.

Fifty-eight thousand seven hundred sixty-five pediatric patients were admitted for trauma and ocular injuries. The mean(SD) age was 11.9(6.9) years. Most patients were male (68.7%) and White (59.1%). Unintentional injuries (76.3%) were mostly associated with falls (OR = 13.4, p < 0.001), assault (16.3%) with firearms (OR = 9.15, p < 0.001) and self-inflicted trauma (0.7%) also with firearms (OR = 44.66, p < 0.001). There was increasing mean(SD) age from unintentional, 12.9(6.6) years and assault 12.3(8.1) years to self-inflicted trauma, 17(3.4) years. The 0-3 year age group had highest odds of open adnexa wounds (OR = 30.45, p < 0.001) from unintentional trauma, and traumatic brain injury (TBI) (OR = 5.77, p < 0.001) and mortality (OR = 8.52, p < 0.001) from assault. The oldest 19-21 year group, had highest odds visual pathway injuries (OR = 8.34, p < 0.001) and TBI (OR = 1.54, p = 0.048) from self-inflicted trauma and mortality (OR = 2.08, p < 0.001) from unintentional trauma.

Sight-threatening injuries were mostly associated with unintentional trauma in the youngest group and self-inflicted trauma in the oldest group. Patterns emerged of associations between demographic groups, mechanisms, types of injury and associated TBI with intention of trauma.