Factors related to incidence of eye disorders in Korean patients at intensive care units

Abstract

AIMS: the purpose of this study was to identify the incidence rate of eye disorders and further to identify factors related to incidence of eye disorders in intensive care unit patients.

BACKGROUND: Although the incidence of eye disorders in intensive care unit patients is very high, it is difficult to come to an accurate estimate of number of eye disorders in intensive care unit patients because eye disorders are often perceived to be minor problems.

DESIGN: A retrospective, descriptive survey design was used.

METHOD: the medical records of a total 235 patients with eye disorders were identified through a review of the medical records of 2,500 patients hospitalised in the intensive care units of Yonsei University Hospital, Seoul, Korea from January to December, 2004. To examine factors related to eye disorders, 522 patients without eye disorders from the cohort of 2,265 patients were randomly selected. Factors related to incidence of eye disorder were included in a multiple logistic regression model, after screening by the chi-squared test.

RESULTS: the incidence rate for eye disorders in the intensive care unit patients was 8.6%. From the multiple regression model, the following odds ratios (95% confidence intervals) of eye disorder were estimated; length of stay in intensive care unit of at least seven days: 2.8 (1.70-4.70); death: 2.5 (1.47-4.29); drowsy mental state: 2.2 (1.10-4.37); stupor mental state: 7.0 (3.20-15.45); coma mental state: 10.8 (3.47-33.74); no self-respiration: 1.9 (1.00-3.52); positive end expiratory pressure: 2.9 (1.66-4.92); sedatives: 4.2 (2.26-7.74); muscle relaxants: 2.3 (1.11-4.95).

CONCLUSIONS: Factors related to incidence of eye disorders in intensive care unit patients identified in this study support the need to pay attention to eye problems and eye care in intensive care unit patients.

RELEVANCE TO CLINICAL PRACTICE: An evidence-based eye care protocol should be provided as routine care to prevent eye complication, especially in critically ill patients with mechanical ventilators, positive end expiratory pressure, sedatives or muscle relaxants and for patients whose mental status is decreased.