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• W3107385572 abstract "<h3>Importance</h3> Orbital fractures are common in ocular trauma, and there is a need to develop predictive tools to estimate risk of concurrent ocular injury. <h3>Objective</h3> To identify clinical and radiographic features that are associated with increased risk of substantial ocular injury in the setting of orbital fracture. <h3>Design, Setting, and Participants</h3> Retrospective consecutive case series of patients who sustained orbital fractures between 2012 and 2018. Examinations were done at 1 of 2 level 1 trauma centers in the emergency or inpatient setting. A total of 430 consecutive patients (500 eyes) between 2012 and 2017 met inclusion criteria for the training sample. After building a predictive model, 88 additional consecutive patients (97 eyes) between 2017 and 2018 who met inclusion criteria were collected as a test sample. <h3>Main Outcomes and Measures</h3> The primary outcome measure was substantial ocular injury distinct from orbital fracture. <h3>Results</h3> The mean age of our patient population was 53.5 years (range, 16-100 years). The overall rate of substantial ocular injury was 20.4%, and the rate of injury requiring immediate ophthalmic attention was 14.4%. Five variables were found to be associated with increased risk of substantial ocular injury: blunt trauma with a foreign object (odds ratio [OR], 19.4; 95% CI, 6.3-64.1;<i>P</i> < .001), inability to count fingers (OR, 10.1; 95% CI, 2.8-41.1;<i>P</i> = .002), roof fracture (OR, 9.1; 95% CI, 2.8-30.0;<i>P</i> = .002), diplopia on primary gaze (OR, 6.7; 95% CI, 1.7-25.1;<i>P</i> = .003), and conjunctival hemorrhage or chemosis (OR, 4.2; 95% CI, 2.2-8.5;<i>P</i> < .001). The results were translated into a bedside tool that was tested in an independent group of eyes (n = 97) and found to be associated with substantial ocular injury with a 95% sensitivity (95% CI, 77.2-99.9), 40% specificity (95% CI, 28.9-52.0), 31.8% positive predictive value (95% CI, 27.5-36.5), and 96.8% negative predictive value (95% CI, 81.3-99.5). <h3>Conclusions and Relevance</h3> A minority of patients with an orbital fracture had a substantial ocular injury. Certain radiographic and clinical findings were associated with substantial ocular injury. Testing of the algorithm in prospective longitudinal settings appears warranted." @default.
• W3107385572 created "2020-12-07" @default.
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• W3107385572 date "2021-01-01" @default.
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• W3107385572 title "Factors Associated With Increased Risk of Serious Ocular Injury in the Setting of Orbital Fracture" @default.
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• W3107385572 doi "https://doi.org/10.1001/jamaophthalmol.2020.5108" @default.
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