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社会脆弱性指数对严重视力障碍或由眼引起的失明的发展的影响

Swarup S Swaminathan¹, Felipe A Medeiros¹, Steven J Gedde¹

¹From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (S.S.S., F.A.M., S.J.G.), Miami, Florida, USA.

American journal of ophthalmology

|July 6, 2024

概括

地理编码的社会风险因素,包括社会经济地位和住房,预测眼患者的严重视力损失. 将社会脆弱性数据与电子健康记录相结合,可以识别有风险的个人,以便更好地管理青光眼.

科学领域:

眼科医生眼科眼科
公共卫生公共卫生
医疗信息学医疗信息学

背景情况:

玻璃眼是全球不可逆转的失明的主要原因.
识别严重视力障碍或失明高风险的个体对于及时干预至关重要.
健康的社会决定因素越来越被认为是影响健康结果的重要因素.

研究的目的:

为了确定地理编码的社会风险因素数据是否预测了青光眼患者的严重视力障碍或失明的发展.
为此评估使用大型电子健康记录 (EHR) 数据库.

主要方法:

一项队列研究,涉及诊断为开角玻璃眼 (OAG) 的患者,现有视野缺陷.
从电子健康记录中提取社会人口统计和眼部数据,包括基线严重程度和眼内压力 (IOP).
基于患者居住地的地理编码社会脆弱性指数 (SVIndex) 数据的整合;使用混合效应Cox比例危险模型进行分析.

主要成果:

在平均4.3年的随访期间,2.7%的患者出现严重的视力损伤或失明.
年龄较大,基线光瘤严重程度较高,随访IOP升高和SVIndex更高是显著的危险因素.
特定的SVIndex主题,如社会经济地位,少数民族地位/语言,住房/交通是主要贡献者.

结论:

社会脆弱性,与传统的眼部因素一起,是绿眼病中严重视力丧失的重要预测因素.
来自EHR的地理编码的社会风险因素数据可以增强识别高风险玻璃眼患者的能力.
这种方法支持主动策略,以防止与眼相关的视力障碍.

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