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To investigate factors associated with prolonged length of stay and high cost among pediatric hospitalizations with a primary ophthalmic diagnosis. This retrospective, cross-sectional study utilized data on pediatric admissions with a primary ophthalmic diagnosis from the multicenter 2016 Kids' Inpatient Database. Multivariable logistic regression models adjusted for demographic, hospital, and admission characteristics were used to evaluate factors associated with prolonged stay and high cost, defined as exceeding the 75th percentile (>4 days and $12,642, respectively). An estimated 6,811 pediatric hospitalizations with a primary ophthalmic diagnosis in the United States in 2016 were included. On adjusted analysis, a prolonged length of stay was more likely with Medicaid (vs. private insurance, OR = 1.19, 95% CI: [1.02, 1.40], p =.03), non-trauma (vs. trauma, OR = 2.77, 95% CI: [2.12, 3.63], p <.001) and urban teaching hospitals (vs. rural, OR = 3.48, 95% CI: [1.04, 11.69], p =.04). A high cost of stay was more likely with higher income levels (Quartile 3 vs. 1, OR = 1.30, 95% CI: [1.02, 1.67], p =.04; Quartile 4 vs. 1, OR = 1.49, 95% CI: [1.08, 2.05], p =.02), private insurance (vs. Medicaid, OR = 1.26, 95% CI: [1.04, 1.53], p =.02), Western hospitals (vs. South, OR = 2.74, 95% CI: [1.83, 4.12], p <.001), and trauma (vs. non-trauma, OR = 3.29, 95% CI: [2.57, 4.21], p <.001). Children and young adults had higher odds of prolonged stay, while adolescents and young adults had higher odds of high cost compared to toddlers (p <.05 for all). Additional work addressing the factors associated with higher resource utilization may help promote the delivery of quality inpatient pediatric eye care. [ABSTRACT FROM AUTHOR]

Falls is a leading cause of injuries nationally and can lead to serious ophthalmic injuries. The purpose of this study is to examine the incidence and characteristics of ophthalmic trauma in patients with fall-related hospitalizations in the United States. Retrospective, cross-sectional study. National Inpatient Sample (NIS) was queried to identify all ophthalmic trauma associated with fall-related hospitalizations from 2000 to 2017. Patients were identified using relevant International Classification of Diseases (ICD) codes. National estimates, annual incidences and characteristics were produced from trend weights provided by the NIS sampling frame and population data from the US Census Bureau. There were 21,415,120 fall-related hospitalizations of which 425,725 (2.0%) had ophthalmic trauma. Ophthalmic injury incidence increased from 4.26 to 14.31 per 100,000 population (P <.01) from 2000 to 2017. Mean (±SEM) age was 69.2 ± 20.1 years and 56.9% were females. Of the patients with specified fall mechanism, the most common mechanisms were tripping or stumbling (48.0%), falls related to furniture (18.3%), and falls related to stairs (16.3%). The most common ophthalmic injuries were contusions of the eye and adnexa including hyphema and commotio retinae (50.1%), orbital fractures (20.7%), and eyelid lacerations (14.9%). Incidence of ophthalmic trauma in patients with fall-related hospitalizations has increased and our study provides valuable information for targeting preventive measures particularly for the elderly and falls due to tripping, stairs, and furniture related accidents. The most common associated ophthalmic injuries are contusions, orbital fractures and eyelid lacerations. [ABSTRACT FROM AUTHOR]