Risk of physical injuries in children and teens with ophthalmic diagnoses in the OptumLabs Data Warehouse.


Journal

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
ISSN: 1528-3933
Titre abrégé: J AAPOS
Pays: United States
ID NLM: 9710011

Informations de publication

Date de publication:
12 2021
Historique:
received: 20 05 2021
revised: 16 07 2021
accepted: 17 07 2021
pubmed: 17 10 2021
medline: 18 3 2022
entrez: 16 10 2021
Statut: ppublish

Résumé

To evaluate how eye diseases affect the risk of injuries (fractures, musculoskeletal, head and eye injuries) in children and teens. Claims from the OptumLabs Data Warehouse, a longitudinal deidentified commercial insurance claims database, were analyzed. Eligible subjects were aged <19 years at the time of their eye disease diagnosis, enrolled in the health plan between 2007 and 2018, and had >1 visit for >1 significant eye disease (strabismus, amblyopia, nystagmus, structural diseases), based on ICD9/10 codes. Controls were children in the same database who had no eye disease codes reported. Demographics and injury claims (fractures, musculoskeletal injuries, head injuries and eye injuries) were compared. The overall incidence of any subsequent physical injury (even into adulthood) was 29% in eye disease patients and 23% in controls (P < 0.001). After accounting for covariates, the hazard ratio for injury with any type of eye disease was 1.14 (95% CI, 1.13-1.15), 1.17 (95% CI, 1.16-1.18), 0.97 (95% CI, 0.96-0.98), and 1.63 (95% CI, 1.60-1.66) for musculoskeletal injuries, fractures, head injuries, and eye injuries, respectively. The eye disease with the highest adjusted injury risk was nystagmus (HR = 1.26; 95% CI, 1.23-1.28), followed by optic neuritis and pseudotumor cerebri (HR = 1.25). The eye diseases with the lowest risk included amblyopia, esotropia, and glaucoma (HR ≤ 1.06). There was an increased long-term risk of physical injury among children and teens with eye disease. The clinical significance of these small differences is unclear.

Sections du résumé

BACKGROUND
To evaluate how eye diseases affect the risk of injuries (fractures, musculoskeletal, head and eye injuries) in children and teens.
METHODS
Claims from the OptumLabs Data Warehouse, a longitudinal deidentified commercial insurance claims database, were analyzed. Eligible subjects were aged <19 years at the time of their eye disease diagnosis, enrolled in the health plan between 2007 and 2018, and had >1 visit for >1 significant eye disease (strabismus, amblyopia, nystagmus, structural diseases), based on ICD9/10 codes. Controls were children in the same database who had no eye disease codes reported. Demographics and injury claims (fractures, musculoskeletal injuries, head injuries and eye injuries) were compared.
RESULTS
The overall incidence of any subsequent physical injury (even into adulthood) was 29% in eye disease patients and 23% in controls (P < 0.001). After accounting for covariates, the hazard ratio for injury with any type of eye disease was 1.14 (95% CI, 1.13-1.15), 1.17 (95% CI, 1.16-1.18), 0.97 (95% CI, 0.96-0.98), and 1.63 (95% CI, 1.60-1.66) for musculoskeletal injuries, fractures, head injuries, and eye injuries, respectively. The eye disease with the highest adjusted injury risk was nystagmus (HR = 1.26; 95% CI, 1.23-1.28), followed by optic neuritis and pseudotumor cerebri (HR = 1.25). The eye diseases with the lowest risk included amblyopia, esotropia, and glaucoma (HR ≤ 1.06).
CONCLUSIONS
There was an increased long-term risk of physical injury among children and teens with eye disease. The clinical significance of these small differences is unclear.

Identifiants

pubmed: 34655769
pii: S1091-8531(21)00547-4
doi: 10.1016/j.jaapos.2021.07.007
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

346.e1-346.e7

Subventions

Organisme : NIEHS NIH HHS
ID : R21 ES029655
Pays : United States

Informations de copyright

Copyright © 2021 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Auteurs

Stacy L Pineles (SL)

Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles; OptumLabs, Eden Prairie, Minnesota. Electronic address: pineles@jsei.ucla.edu.

Michael X Repka (MX)

Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Fei Yu (F)

Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles; Department of Biostatistics, University of California Los Angeles, Fielding School of Public Health.

Federico G Velez (FG)

Department of Ophthalmology, Doheny Eye Institute, University of California, Los Angeles; Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.

Danielle Doppee (D)

Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles.

Claudia Perez (C)

Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles.

Danielle Sim (D)

Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles.

Anne L Coleman (AL)

Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles; Department of Epidemiology, University of California Los Angeles, Fielding School of Public Health.

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