Epidemiology and mortality-related prognostic factors in endophthalmitis

Abstract

PURPOSE. Endophthalmitis describes any intraocular inflammation that involves both the posterior and anterior segments and is divided into endogenous and exogenous types according to its pathogenesis. The incidence of endophthalmitis and its risk factors have been extensively evaluated. However, few studies have explored the mortality rate in patients diagnosed with endophthalmitis. METHODS. We obtained data entered into the National Health Insurance Research Database (NHIRD) from 2000 to 2013. The data collected included all discharge diagnoses of endophthalmitis in inpatients. Baseline characteristics, comorbidities, and prognostic factors were evaluated. RESULTS. This study identified 7764 patients who were diagnosed with endophthalmitis in Taiwan from 2000 to 2013. The mortality rate was 0.97% (75/7764), and the mean age was 63.57 ± 15.72 years. Epidemiological characteristics were compared as ‘‘with or without’’ for different systemic comorbidities, and the results indicated that the adjusted odds ratio (AOR) was significantly higher in cases comorbid with renal disease (AOR 2.864, P = 0.001), septicemia (AOR 8.886, P < 0.001), pneumonia (AOR 2.072, P = 0.030), and tumors (AOR 7.437, P < 0.001). However, comorbidity with diabetes mellitus (DM) lowered the AOR by 0.500-fold (P = 0.026). There was no significant difference in ORs between patients comorbid with hypertension, depression, anxiety, hyperlipidemia, thyrotoxicosis, liver disease, or injury (all P > 0.05). CONCLUSIONS. Among inpatients with endophthalmitis, predictors of mortality include renal disease, septicemia, pneumonia, neoplasia, a greater burden of comorbidity (especially catastrophic illness), longer hospital stays (more than 11 days), and higher medical costs. Interestingly, DM decreased the OR for inpatient mortality.