Trends and risk factors among adults admitted to the emergency department with fall-related eye injuries

Abstract

Background/purpose: Eye injuries can happen to people of any age and for many reasons; among these is a fall. The aims of this study were to: (1) examine trends among fall-related eye injuries in working-age and older adults admitted to the emergency department (ED) from 2012 to 2021; and (2) investigate and compare the risk factors associated with fall-related eye injuries between working-age adults and older adults.

Design: We examined a retrospective cohort in the 2012-2021 National Electronic Injury Surveillance System (NEISS) databases. We used the Cochran-Armitage test for trend to determine the fall-related eye injury trend from 2012 to 2021. The associations among fall-related eye injuries, demographics, accident-related environments, and disposition, were analyzed using multivariable logistic regression analysis.

Results: Among the total of 1,290,205 adults with eye injuries from 2012 to 2021, the incidence rate of fall-related eye injuries was higher in older adults (ranged from 9.0% to 17.4%) than in working-age adults (ranged from 3.7% to 7.1%). Over consecutive years, the number and annual incident rate of both working-age and older adults experiencing fall-related eye injuries increased significantly (all p ≤0.001). Patients who were female (odds ratio [OR] = 1.60, 95% confidence interval [CI] = 1.39-1.83), Black/African American (OR = 1.76, 95% CI = 1.47-2.10) had significantly higher odds of fall-related eye injuries. The highest odds ratios found among all of the reported product categories for the fall-related eye injuries were an accident with home structures such as doors (OR = 12.65, 95% CI = 10.00-16.01) and an accident with home furnishings (OR = 11.65, 95% CI = 9.18-14.78) compared to an accident with workshop equipment. Patients who experienced fall-related eye injuries were more likely to be hospitalized/ have an inpatient stay (OR = 7.41, 95% CI = 5.78-9.52) after the ED treatment than those who treated and released after ED visit.

Conclusion: Among Americans treated in the ED for injury, fall-related eye injuries are increasingly common, especially among older adults, and associated with a need for inpatient care. Therefore, these findings suggest opportunities to investigate fall prevention and eye protection interventions, especially in the home setting.

Keywords: Emergency department; Eye trauma; Fall-related eye injury; Falls.