The effect of age and ethnic background on the natural rebleed rate in untreated traumatic hyphema in children.

Abstract

Controlling the natural tendency to rebleed in this condition is important because the serious vision threatening complications usually follow rebleeds. In evaluating treatments, it has been difficult to determine the natural rebleed rate. Recent reports on traumatic hyphema suggest that the natural rebleed rate in this condition may be higher in blacks and young children than in Caucasians and older children and adults. The records of 38 patients who were admitted to a children's hospital and who were the untreated control group in a previous study on systemic steroid treatment for traumatic hyphema, were reviewed to determine their ethnic background and age. The data was examined to see if these characteristics were related to the rebleed rate. The overall rebleed rate in this untreated group was 32% (12 out of 38). For specific ethnic groups, the rebleed rate was: Caucasians, including presumed Hispanics--32% (10 out of 31); Caucasians, not including presumed Hispanics--33% (8 out of 24); presumed Hispanics--29% (2 out of 7). There was no statistically significant (P greater than .95) difference in rebleed rates. With regard to age, the rebleeding rate was 54% (6 out of 11) for children under six years of age, and 22% (6 out of 27) for those over six years of age. This was a statistically significant difference (P less than .05). Ethnicity, therefore, in this group of untreated patients did not affect the natural rebleed rate. Younger age, under six years, is associated with a higher natural rebleed rate in traumatic hyphema, and these children should be most carefully treated.