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Dryad

Socioeconomic status and decreasing incidence of ocular injuries in Bosnia and Herzegovina

Cite this dataset

Zvorničanin, Jasmin; Zvorničanin, Edita (2021). Socioeconomic status and decreasing incidence of ocular injuries in Bosnia and Herzegovina [Dataset]. Dryad. https://doi.org/10.5061/dryad.rn8pk0p70

Abstract

Purpose: To examine the epidemiologic and clinical characteristics of ocular injuries and their association with socioeconomic status (SES).

Material and Methods: All cases of ocular injuries hospitalized in Department of Ophthalmology of University Clinical Center Tuzla, Bosnia and Herzegovina, from January 2009 to December 2012 and January 2017 and December 2019 were prospectively followed. The injuries were classified according to Ocular Trauma Classification System (OTCS) and Birmingham Eye Trauma Terminology (BETT).

Results: This study included a total of 420 eyes from 396 patients. There were 162 (38.57%; 95%CI:32.86–44.99) open globe injuries (OGI) and 258 (61.43%; 95%CI: 54.16–69.4) closed globe injuries (CGI). The decrease in incidence of ocular trauma requiring hospitalization was noted from 16.7 per 100 000 (95%CI: 13.11–20.97) in 2009 to 9.25 per 100 000 (95%CI: 6.64–12.55) in 2019 (p=0.006). Most injuries occurred in males 341 (81.19%; 95%CI: 72.8–90.28), active working patients 258 (61.43%, 95%CI:54.16–69.4), and patients with rural residence 285 (67.86%; 95%CI: 60.21–76.21). Almost all ocular injuries 418 (99.52%; 95%CI: 90.21–109.54) occurred in patients with middle and lower SES categories, and home was the most prevalent place of injury in 258 (61.43%, 95%CI: 54.16–69.4) patients. The total of 289 (70.49%; 95%CI: 62.59–79.1) patients had good final best corrected visual acuity (BCVA). Poor final BCVA was associated with lower ocular trauma score (OTS) (p=0.000), poor initial BCVA (p=0.000), penetrating injuries of cornea (p=0.004) and sclera (p=0.001), Zone III injuries (p=0.000), intraocular foreign body presence (p=0.000), cataract (p=0.002), retinal detachment (p=0.001), endophthalmitis (p=0.000) and vitreous hemorrhage (p=0.010).

Conclusion: This study provides a detailed insight into epidemiology and socio-economic characteristics of patients hospitalized for ocular injuries.

README

GENERAL INFORMATION

  1. Title of Dataset: Socioeconomic Status and Decreasing Incidence of Ocular Injuries in Bosnia and Herzegovina

  2. Author Information

    A. Principal Investigator Contact Information
    Name: Jasmin Zvornièanin
    Institution: Department of Ophthalmology, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
    Private Healthcare Institution Vase zdravlje, Tuzla, Bosnia and Herzegovina
    Address: Ulica dr Ibre Pašiæa bb, 75000 Tuzla
    Email:

    B. Associate or Co-investigator Contact Information
    Name: Edita Zvornièanin
    Institution: Department of Ophthalmology, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
    Private Healthcare Institution Vase zdravlje, Tuzla, Bosnia and Herzegovina
    Address: Ulica dr Ibre Pašiæa bb, 75000 Tuzla
    Email:

  3. Date of data collection: First period from: 1st January 2009 to 31st December 2012
    Second period from: 1st January 2017 to 31st December 2019.

  4. Geographic location of data collection: Tuzla Canton, Bosnia and Herzegovina

  5. Information about funding sources that supported the collection of the data:
    No funding was received for this research.

SHARING/ACCESS INFORMATION

  1. Licenses/restrictions placed on the data: NONE

  2. Links to publications that cite or use the data: https://doi.org/10.1080/08820538.2021.1893350
    https://www.tandfonline.com/doi/abs/10.1080/08820538.2021.1893350?journalCode=isio20

  3. Links to other publicly accessible locations of the data: NONE.

  4. Links/relationships to ancillary data sets: NONE.

  5. Was data derived from another source? NO.

  6. Recommended citation for this dataset: Zvornicanin, Jasmin; Zvornièanin, Edita. (2021), Data from: Socioeconomic Status and Decreasing Incidence of Ocular Injuries in Bosnia and Herzegovina, Dryad, Dataset, doi:10.5061/dryad.rn8pk0p70

DATA & FILE OVERVIEW

  1. File List: SES and decreasing incidence of ocular injuries in B&H

  2. Relationship between files, if important: NONE.

  3. Additional related data collected that was not included in the current data package: NONE.

  4. Are there multiple versions of the dataset? NO.
    A. If yes, name of file(s) that was updated:
    i. Why was the file updated?
    ii. When was the file updated?

METHODOLOGICAL INFORMATION

  1. Description of methods used for collection/generation of data:
    https://doi.org/10.1080/08820538.2021.1893350

  2. Methods for processing the data:
    Differences between means were analysed by Student t test. The Chi-square or Fisher exact test was used to assess the differences between categorical variables, and for continuous variables the analysis of variance (ANOVA) was used. A multivariate regression model was used to assess the risk factors for final best corrected visual acuity. Statistically significant p values were considered those <0.05.

  3. Instrument- or software-specific information needed to interpret the data:
    The data were analysed using Stata Statistical Software, version 14.0 (StataCorp LP, College
    Station, Texas, USA).

  4. Standards and calibration information, if appropriate: NONE.

  5. Environmental/experimental conditions: NONE.

  6. Describe any quality-assurance procedures performed on the data: All data was double checked when data was acquired and entered in excel file.

  7. People involved with sample collection, processing, analysis and/or submission:
    Jasmin Zvorničanin and Edita Zvorničanin

DATA-SPECIFIC INFORMATION FOR: [SES and decreasing incidence of ocular injuries in B&H]

  1. Number of variables: 43

  2. Number of cases/rows: 420

  3. Variable List:

    1. Year12 – Patients were grouped in two groups, from the first and second study period.
    2. AgeGroup18-65 – Age was categorized into three groups: less than 18, 18–65 and more than 65 years.
    3. Gender - Male or Female.
    4. Rural/Urban – Based on place of residence patients were grouped into 2 categories: Rural or Urban.
    5. OccupatCateg - Occupations were grouped into five categories: manual workers, fire and explosion hazard workers, agricultural workers, not working, and other.
    6. Employment – If patient was officially employed at the time of the injury.
    7. EmployCateg - Category of employment as described in Methods.
    8. Education – Level of education as described in Methods.
    9. SESscore – Socio-economic score as described in Methods.
    10. SESCateg - Based on the index of social position values, all patients were categorized into three social classes: upper (11–27), middle (28–43), and lower social class (44–77).
    11. Season - Season of injury: spring, summer, fall, winter.
    12. Workday – If injury occurred on working day or weekend.
    13. InjuryOnset81624 - Time of the injury onset (working time 8 am–3 pm, afternoon 4 pm–11pm and late evening time 12 pm–7 am).
    14. TimeToAdmision2122448 - time from the injury occurrence to hospital admission (less than 2 h, 2–12 h, 12–48 h and more than 2 days).
    15. LengthHospital714 – duration of hospitalization (1–6 days; 7–13 days and 14 days or more).
    16. LocationInjury – According to the location of ocular injury, the data were classified into six groups: work-related injuries, home-related injuries, recreational/sport- related injuries, road accident-related injuries, assaults-related injuries, and other various outdoor activities related injuries.
    17. EyeProtectWork - Information on the use of eye protection in work related injuries.
    18. WorkInjury – If injury occurred at the working place.
    19. Mechanism - According to injury mechanism, patients were grouped into the following categories: blunt force object, sharp force object, road and explosion, biologic or organic material, and other injuries.
    20. BETTtype - The injuries were classified by Birmingham Eye Trauma Terminology.
    21. TypeOC – Type of ocular injury: closed globe injury (CGI) or open globe injury (OGI).
    22. EyesNumb – Number of eyes affected: one or both eyes.
    23. SideR1L0 – Side of the affected eye, right or left.
    24. Cornea - If cornea was affected by the injury.
    25. Sclera - If sclera was affected by the injury.
    26. AntChamber - If anterior chamber was affected by the injury.
    27. Hyphaema – If hyphaema was present at the hospital admission.
    28. LensStatus – Status of the crystalline lens at the hospital admission.
    29. Cataract – Presence of cataract at the time of the hospital admission.
    30. Vitreous - If corpus vitreum was affected by the injury.
    31. Haematovitreus – If there was vitreous hemorrhage at the hospital admission.
    32. Retina - If retina was affected by the injury.
    33. RetDetachment – If there was retinal detachment present at the hospital admission
    34. IOFB – If there was Intraouclar foreign body at the hospital admission.
    35. EOFB - If there was extraocular foreign body at the hospital admission.
    36. PeriorbitAdnex - If periorbit and ocular adnexa were affected by the injury.
    37. OTSCateg –The ocular trauma score (OTS) was categorized into: category 1 low OTS - categories one, two, and three and category 2 high OTS including categories four and five.
    38. OTCS - According to the Ocular Trauma Classification System (OTCS) and based on the wound location all injuries were classified as follows: Zone I, Zone II and Zone III injuries.
    39. InitialVA – Visual acuty at the hospital admission.Initial and final BCVA were classified as no light perception (NLP), light perception (LP)/hand motion (HM), 1/200–19/200, 20/200–20/50, and ≥20/40.
    40. FinalVA – Visual acuity at the hospital discharge.
    41. VisualOutcome - The final visual acuity of ≥ 20/200 was defined as good and final visual acuity of less than 20/200 as poor visual outcome.
    42. Improvement – Improvement in visual acuity based on initial and final visual outcome.
    43. NumberSurg – Number of surgical procedures during the hospitalization.
  4. Missing data codes: NONE

  5. Specialized formats or other abbreviations used:
    PCIOL – posterior chamber intraocular lens

Methods

Material and methods
This prospective epidemiological study included all consecutive patients with ocular injuries hospitalized in Department of Ophthalmology, University Clinical Center Tuzla, Bosnia and Herzegovina. The study covered two time periods, the first from 1 January 2009 to 31 December 2012 and the second from 1 January 2017 to 31 December 2019. The current study was approved by the University Clinical Center Tuzla Ethics Committee on September 1, 2008 (Approval number: 32-1-2008). A written informed consent was obtained from all patients and tenets of the Helsinki Declaration were followed.

University Clinical Center Tuzla is the only tertiary referral center that serves as the main health institution in the Tuzla Canton. It offers the emergency and specialized eye care for patients with ocular or orbital conditions. Tuzla Canton is in the north eastern part of Bosnia and Herzegovina. It covers the area of 2649 square km with 445028 inhabitants. The economy includes industries, commerce, agriculture, tourism, handicraft, and services. During eleven year period from 2009 to 2020, the population of Tuzla canton was relatively stable.13

In this study, ocular injury was defined as any injury of the eye or adnexa requiring hospitalization.14 The following demographic variables were recorded: age, sex, side of the eye involved, place of residence, level of education, occupation, and employment status. According to the Labor Law of Bosnia and Herzegovina, persons aged 18-65 are considered able to work. Therefore, for the purposes of this study, age was categorized into three groups: less than 18, 18-65, more than 65 years.12 Based on the highest level of formal education and occupation Hollingshead Two-Factor Index of Social Position (ISP) was calculated.15 Education level and job position were assigned with numeric values ranging 1-7, and multiplied with weighted scores 7 and 4 for occupation and education, respectively. The obtained values were combined to obtain ISP. For patients younger than 18 years the SES was calculated based on status of both parents. Based on the ISP values, all patients were categorized into three social classes: upper (11-27), middle (28-43), and lower social class (44-77). Occupations were grouped into five main categories: manual workers, fire and explosion hazard workers, agricultural workers, not working, and other.12

Injury information included: time of the injury onset (working time 8am-3pm, afternoon 4pm-11pm and late evening time 12pm-7am), season of injury (spring, summer, fall, winter), time from the injury occurrence to hospital admission (less than 2h, 2-12h, 12-48h and more than 2 days), duration of hospitalization (1-6 days; 7-13 days and 14 days or more) and information on the use of eye protection. According to the location of ocular injury, the data were classified in six groups: work related injuries, home related injuries, recreational/sport related injuries, road accident related injuries, assaults related injuries, and other various outdoor activities related injuries.14 According to injury mechanism patients were grouped into following categories: blunt force object, sharp force object, road and explosion, biologic or organic material, and other injuries.12

Clinical eye injury variables included types of injury categorized as closed (CGI) or open globe injuries (OGI). Other clinical signs such as: eyelid laceration, hyphaema, lens injury, and vitreous haemorrhage, were also recorded. The injuries were classified by Birmingham Eye Trauma Terminology (BETT), and the Ocular Trauma Score (OTS) was calculated subsequently.16,17 For the purposes of this study the OTS categories one, two, and three were grouped as category 1 (low OTS), and categories four and five as category 2 (high OTS).12 According to the wound location all injuries were classified as: Zone I, Zone II and Zone III injuries defined by Ocular Trauma Classification System (OTCS).18 The initial best corrected visual acuity (BCVA) was measured upon the hospital admission, while the final BCVA was taken on the hospital discharge. Initial and final BCVA were classified as no light perception (NLP), light perception (LP)/hand motion (HM), 1/200–19/200, 20/200–20/50, and ≥20/40. The final BCVA ≥ 20/200 was defined as good and final BCVA of less than 20/200 as poor visual outcome.19,20

Differences between means were analysed by Student t test. The Chi-square or Fisher exact test were used to assess the differences between categorical variables, and for continuous variables the analysis of variance (ANOVA) was used. A multivariate regression model was used to assess the risk factors for final BCVA. Statistically significant P values were considered those <0.05. The data were analysed using Stata Statistical Software, version 14.0 (StataCorp LP, College Station, Texas, USA).