ImportanceThe length of stay (LOS) of hospitalizations may be a useful indicator of the burden of disease of corneal ulcers. Identifying variables associated with longer LOS may help to enhance delivery of care for high-risk patients.ObjectiveTo investigate the sociodemographic, social, and clinical factors associated with LOS in hospitalizations for corneal ulcers in the US.Design, Setting, and ParticipantsThis was a retrospective cross-sectional study of adult patients (aged >18 years) admitted with a primary diagnosis of corneal ulcer between quarter 4 of 2015 through 2020 and conducted using data from the National Inpatient Sample (NIS). Patients were stratified into 2 even cohorts based on LOS: LOS of 4 days or less and LOS greater than 4 days. Individual-level sociodemographic, social risk factors, and medical comorbidities associated with longer LOS were examined by multivariable regression. Data were analyzed from October 2015 to December 2020.ExposurePotential sociodemographics or medical comorbidities at hospital admission.Main Outcome and MeasureThe primary outcome of interest was factors associated with extended length of stay. The hypothesis being tested was formulated during data collection.ResultsA total of 1187 patients (mean [SD] age, 53.5 [20.9] years; 602 female [50.7%]) were included for analysis. The cohort with LOS greater than 4 days had higher total charges than the cohort with LOS of 4 days or less (mean [SD] charges, $79 504 [$86 719] vs $26 474 [$20 743]; P < .001). Sociodemographic variables associated with LOS greater than 4 days were Black race (adjusted odds ratio [aOR], 1.41; 95% CI, 1.03-1.92; P = .03), Medicare insurance (aOR, 1.42; 95% CI, 1.09-1.85; P = .009), and housing insecurity (aOR, 1.99; 95% CI, 1.29-3.06; P = .002). Medical comorbidities associated with LOS greater than 4 days were alcohol use (aOR, 1.50; 95% CI, 1.00-2.26; P = .05), dementia (aOR, 2.35; 95% CI, 1.36-4.07; P = .002), complicated diabetes (aOR, 1.75; 95% CI, 1.21-2.53; P = .003), uncomplicated diabetes (aOR, 1.57; 95% CI, 1.02-2.42; P = .04), drug misuse (aOR, 1.66; 95% CI, 1.08-2.57; P = .02), and legal blindness (aOR, 3.42; 95% CI, 1.19-9.82; P = .02). Based on NIS national estimates, corneal ulcers were estimated to have a direct annual health care expenditure of $35 819 590 in the US.Conclusion and RelevanceCorneal ulcer hospitalizations represent a significant burden of disease for patients and health care systems. This study highlights sociodemographic and clinical factors that may help clinicians identify high-risk patients vulnerable to complications and morbidity due to corneal ulcers.

中文翻译：

---

角膜溃疡住院时间延长的社会人口学和临床预测因素

重要性住院时间（LOS）可能是角膜溃疡疾病负担的有用指标。识别与较长 LOS 相关的变量可能有助于加强对高危患者的护理。目的调查美国角膜溃疡住院患者中与 LOS 相关的社会人口统计学、社会和临床因素。设计、设置和参与者这是一项回顾性研究这项横断面研究针对 2015 年第 4 季度至 2020 年期间因初步诊断为角膜溃疡而入院的成年患者（年龄 > 18 岁），并使用来自国家住院患者样本 (NIS) 的数据进行。根据 LOS，将患者分为 2 个偶数组：LOS 为 4 天或更少，LOS 大于 4 天。通过多变量回归分析了个体层面的社会人口统计学、社会风险因素以及与较长 LOS 相关的医疗合并症。数据分析时间为 2015 年 10 月至 2020 年 12 月。暴露入院时潜在的社会人口统计学或医疗合并症。主要结果和测量感兴趣的主要结果是与延长住院时间相关的因素。所测试的假设是在数据收集过程中制定的。 结果共有 1187 名患者（平均 [SD] 年龄，53.5 [20.9] 岁；602 名女性 [50.7%]）纳入分析。LOS 超过 4 天的队列的总费用高于 LOS 为 4 天或更少的队列（平均 [SD] 费用为 79 504 美元 [86 719 美元] vs 26 474 美元 [20 743 美元]；磷< .001）。与 LOS 超过 4 天相关的社会人口统计学变量为黑人种族（调整后优势比 [aOR]，1.41；95% CI，1.03-1.92；磷= .03)，医疗保险（aOR，1.42；95% CI，1.09-1.85；磷= .009）和住房不安全（aOR，1.99；95% CI，1.29-3.06；磷= .002)。与 LOS 超过 4 天相关的医疗合并症是饮酒（aOR，1.50；95% CI，1.00-2.26；磷= .05)，痴呆（aOR，2.35；95% CI，1.36-4.07；磷= .002），复杂性糖尿病（aOR，1.75；95% CI，1.21-2.53；磷= .003)，无并发症的糖尿病（aOR，1.57；95% CI，1.02-2.42；磷= .04），药物滥用（aOR，1.66；95% CI，1.08-2.57；磷= .02）和法定失明（aOR，3.42；95% CI，1.19-9.82；磷= .02)。根据 NIS 国家估计，在美国，角膜溃疡每年的直接医疗保健支出估计为 35 819 590 美元。结论和相关性角膜溃疡住院给患者和医疗保健系统带来了重大的疾病负担。这项研究强调了社会人口统计学和临床​​因素，可以帮助临床医生识别容易因角膜溃疡而发生并发症和发病的高危患者。