Risk Factors for Acute Endophthalmitis after Cataract Surgery: A Population-based Study
Risk Factors for Acute Endophthalmitis after Cataract Surgery: A Population-based Study
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DOI：
10.1016/j.ophtha.2008.09.039
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发表时间：
2009-03-01
期刊：
影响因子：
13.7
通讯作者：
Bell, Chaim M.
中科院分区：
文献类型：
--
作者：
Hatch, Wendy V.;Cernat, Geta;Bell, Chaim M.
目的：确定白内障手术后疑似急性眼内炎的危险因素。设计：以人群为基础的回顾队列。参与者：2002年4月1日至2006年3月31日在加拿大安大略省连续进行的44万多例白内障手术的管理数据。方法：确定连续的医生白内障手术账单以及与白内障手术并发症相关的术中和术后具体操作。急性眼内炎的定义是使用眼内感染的替代标记物，包括玻璃体切除、玻璃体注射或未联合空气/液体交换或脱位晶状体摘除的抽吸手术，在白内障手术后1-14天进行。主要观察指标：计算眼内炎的总体发生率，并根据患者的人口统计、手术设施、季节、年份以及与囊膜破裂的关系进行分组。结果：在4年中，442,177例白内障手术中有617例疑似急性眼内炎病例。疑似急性眼内炎的总体未调整和调整比率均为每1000例白内障手术中1.4例。男性手术率(1.70/1000例)高于女性(1.19/1000例，P=85岁)，最高(2.18/1000例)，最小年龄组(20岁-)次之(1.76/1000例)。这些年龄组的眼内炎发病率与65岁至84岁的人群相比有显著差异。有囊膜破裂者的眼内炎发生率约为无囊膜破裂者的10倍(13.11比1.34/1000，P
Objective: To identify risk factors for suspected acute endophthalmitis after cataract surgery.Design: Population-based retrospective cohort.Participants: Administrative data from more than 440,000 consecutive cataract surgeries in Ontario, Canada, from April 1, 2002, to March 31, 2006.Methods: Consecutive physician billing claims for cataract surgery and specific intraoperative and postoperative procedures related to complications of cataract surgery were identified. Acute endophthalmitis was defined using surrogate markers for intraocular infection, including vitrectomy, vitreous injection, or aspiration procedures not in combination with air/fluid exchange or dislocated lens extraction, performed 1 to 14 days after cataract surgery. Anterior vitrectomy performed on the day of surgery was used as a surrogate marker for capsular rupture.Main Outcome Measures: Overall rates of endophthalmitis were calculated and grouped by patient demographics, surgical facility, season, year, and association with capsular rupture.Results: There were 617 suspected acute endophthalmitis cases of 442,177 cataract surgeries over the 4 years. The overall unadjusted and adjusted rates of suspected acute endophthalmitis were both 1.4 per 1000 cataract surgeries. Men had higher rates than women (1.70 vs. 1.19/1000 surgeries, P= 85 years) had the highest rate (2.18/1000), and the youngest group (20-64) had the second highest rate (1.76/1000). The endophthalmitis rates for these age groups were significantly different from those aged 65 to 84 years. The endophthalmitis rate was approximately 10-fold higher in those with capsular rupture compared with those without (13.11 vs. 1.34/1000, P