The role of principal and secondary diagnoses of hospitalized eye trauma: A nationwide cohort in Taiwan, 1996-2010

Purpose To estimate the rate of hospitalized eye trauma in Taiwan and investigate the role between principal and secondary diagnoses of such trauma. Methods Nationwide fixed cohort study of 1,000,000 beneficiaries from the Taiwan Longitudinal Health Database was used and 4819 patients who were hospitalized for eye trauma during 1996-2010 were analyzed. Results During 1996-2010, the incidence rates of hospitalized eye trauma (per 100 000 personyears) were 35.0 (95%confidence interval (CI), 34.0 to 36.0) for total diagnosis, 9.8 (95%CI, 9.3 to 10.3) for a principal diagnosis, and 25.3 (95% CI, 24.4 to 26.1) for a secondary diagnosis. The sex risk ratio was 3.1 for a principal diagnosis and 2.1 for a secondary diagnosis. The main causes of eye trauma were traffic accident, work accident, assault (among males <60 years of age), and falls (among elderly men and women). The proportion admitted to an ophthalmic department among those with a principal diagnosis of eye trauma (64.8%) was significantly higher than among those with a secondary diagnosis (2.3%) (p<.0001). Patients with a principal diagnosis of eye trauma had shorter hospital stays (7.1±10.2 days) and lower fatality (0.07%) than those with a secondary diagnosis of eye trauma (10.0±31.6 days and 0.3%, respectively). Conclusion Data only from ophthalmic admissions tends to underestimate the true incidence rate of hospitalized eye trauma. Patients with a principal diagnosis of eye trauma had less severe injuries than did those with a secondary diagnosis.