Epidemiology of Hyphema-Related Emergency Department Visits in The United States Between 2006 and 2015

Purpose: To describe epidemiological trends, risk factors, and hospital-associated charges for patients presenting with hyphema to emergency departments (EDs) throughout the United States (U.S.). Methods: Cross-sectional analysis of all hyphema-related ED cases in the U.S. Nationwide Emergency Department Sample (NEDS) between 2006 and 2015 to determine population-based incidence rates, patient demographics, visit characteristics and associated charges. Results: Between 2006 and 2015, there were a total of 16,222 cases with hyphema as primary visit diagnosis (0.52 ED visits per 100,000 population). The mean (SD) age at presentation was 37.4 (24.8) years, and males accounted for 66.2% of these cases. Trauma (n = 4,994, 30.8%) was the most frequently identified etiology, with sports-related injuries as important contributor. On multivariate analysis, traumatic hyphema was more likely for patients aged 5–14 years (Odds ratio [OR] = 1.88 [95% Confidence interval [CI]: 1.04–3.40, p = 0.04]) than 0–4 years, males (OR = 1.33 [95% CI: 1.09–1.62, p = 0.01]), in May through September (OR = 1.66–1.93 [95% CI: 1.08–3.05, p = 0.005–0.03]),and for those in the highest income quartile (OR = 1.42 [95% CI: 1.10–1.83, p = 0.01]). Visits were less likely for patients aged ≥55 years (OR = 0.49 [95% CI: 0.25–0.994, p = 0.03]) than 0–4 years. During the study period, hyphema accounted for $21 million in ED associated and $9 million in inpatient charges. Conclusion: ED visits with hyphema as primary diagnosis occur at an annual rate of 0.52 per 100,000 population. Young males are particularly at risk and there has been an increase in the number of sports-related injuries which may represent a modifiable cause. Hyphema management costs $3 million in hospital-related charges annually.