Disparities Associated with Discharge Patterns in Firearm-Associated Ocular Trauma.

Area of Science:

• Ophthalmology
• Trauma Surgery
• Health Equity Research

Background:

• Firearm-associated ocular injuries (FAOIs) can lead to severe visual impairment.
• Existing research indicates racial and ethnic disparities in trauma care and post-discharge facility placement.
• Understanding disposition patterns for FAOIs is essential for addressing health inequities.

Purpose of the Study:

• To investigate and describe the patterns of patient disposition following admission for firearm-associated ocular injuries.
• To identify factors influencing discharge destinations for patients with FAOIs.

Main Methods:

• Retrospective analysis of the National Trauma Data Bank (NTDB) from 2008-2014.
• Inclusion of hospitalized trauma cases involving ocular injuries from over 900 US facilities.
• Multivariate analysis to determine factors associated with discharge to advanced care facilities (ACFs).

Main Results:

• Of 8715 patients with FAOIs, 20.5% were discharged to ACFs.
• Factors associated with higher odds of ACF discharge included longer hospital stays, older age, traumatic brain injury, and severe Injury Severity Score.
• White race and Medicare insurance were also associated with increased odds of ACF placement compared to other groups.

Conclusions:

• Significant disparities in discharge disposition exist for patients with FAOIs.
• Older, more severely injured, White patients, and those with Medicare insurance are more likely to be discharged to ACFs.
• These findings highlight potential inequities in rehabilitation access for specific patient populations following firearm-related eye injuries.