Rate of Endophthalmitis After Cataract Surgery in Quebec, Canada, 1996-2005
Rate of Endophthalmitis After Cataract Surgery in Quebec, Canada, 1996-2005
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DOI：
10.1001/archophthalmol.2009.380
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发表时间：
2010-02-01
影响因子：
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通讯作者：
Boisjoly, Helene
中科院分区：
文献类型：
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作者：
Freeman, Ellen E.;Roy-Gagnon, Marie-Helene;Boisjoly, Helene
目的：评估加拿大魁北克省1996年1月1日至2005年12月31日白内障手术后眼内炎的年发病率。方法：从魁北克省国家医疗保险控制中心(RAMQ)的门诊医生账单数据库中获取1996年1月1日至2005年12月31日期间在魁北克省进行的所有白内障手术的明确数据。对于这一队列，同一年的眼内炎国际分类第九修订版(ICD-9)代码的记录来自两个来源：RAMQ门诊数据库和住院出院数据库(住院患者研究数据的维护和利用[MED-ECHO])。如果白内障手术后的眼内炎发生在手术后90天内，则认为是白内障手术后的眼内炎。危险因素采用卡方检验和Logistic回归分析。结果：从1996年1月1日至2005年12月31日，共进行了490 690例白内障手术。共有754例眼内炎发生在术后90天内，总发生率为1.5/1000次手术(95%可信区间[CI]，1.4-1.7)。与眼内炎相关的因素包括年龄85岁或以上(优势比[OR]，1.34；95%CI，1.06-1.70)，男性(1.44；1.24-1.66)，手术时间较晚(0.94；0.92-0.97)，以及白内障手术地区，因为区域6(2.21；1.91-2.55)和9(4.00；结论：白内障术后眼内炎发病率明显下降的原因，特别是2005年，仍需进一步研究，以了解某些患者和地区发生眼内炎的风险较高。
Objective: To estimate the annual incidence of endophthalmitis after cataract surgery from January 1, 1996, through December 31, 2005, in Quebec, Canada.Methods: Deidentified data were obtained from an outpatient physician billing database (Quebec State Control for Health Insurance [RAMQ]) with regard to all cataract surgical procedures performed from January 1, 1996, through December 31, 2005, in Quebec. For this cohort, records of an International Classification of Diseases, Ninth Revision (ICD-9) code for endophthalmitis during the same years were requested from 2 sources: the RAMQ outpatient database and an inpatient hospital discharge database (Maintenance and Exploitation of Data for the Study of Hospitalized Patients [MED-ECHO]). Endophthalmitis after cataract surgery was assumed if it occurred within 90 days of the surgery. Risk factors were examined using chi(2) tests and logistic regression.Results: After exclusions, 490 690 cataract surgical procedures were performed from January 1, 1996, through December 31, 2005. A total of 754 cases of endophthalmitis occurred within 90 days after surgery for an overall incidence rate of 1.5 per 1000 surgical procedures (95% confidence interval [CI], 1.4-1.7). Factors associated with endophthalmitis included age of 85 years or older (odds ratio [OR], 1.34; 95% CI, 1.06-1.70), male sex (1.44; 1.24-1.66), later year of surgery (0.94; 0.92-0.97), and region of cataract surgery, because regions 6 (2.21; 1.91-2.55) and 9 (4.00; 2.48-6.43) had higher rates compared with all other regions.Conclusion: Reasons that explain the apparent decrease in endophthalmitis, especially in 2005, should be explored and further research performed to understand why certain patients and regions have higher risks of endophthalmitis after cataract surgery.