Incidence and risk factors of recurrent ocular injuries: A multicenter retrospective cohort study in four community hospitals, central Thailand

Abstract

Introduction

Recurrent ocular injuries increase the risk of long-term ocular complications, which increases public health and economic burden. This study assesses the incidence and risk factors for recurrent ocular injuries in community hospitals in central Thailand, where industrial and agricultural activities heighten risk.

Methods

This retrospective cohort study enrolled patients from four rural community hospitals over six years (October 1, 2018, to September 17, 2024). Patients with ocular injuries were identified using ICD-10 codes, excluding individuals under 20 and revisits. Data collected included patient demographics, injury characteristics, and healthcare access behaviors. Time-to-event analysis begins from the first ocular injury until a subsequent event or study ends. Statistical analyses identified risk factors, with recurrent events analyzed using the Wei-Lin-Weissfeld model.

Results

Of 7189 ocular injury cases, 4373 (60.8 %) were male, with a median age of 43 (IQR 31–57). Most injuries (79.2 %) occurred in industrial settings. Recurrent injuries accounted for 1628 cases (22.7 %), with a rate of 7.6 per 100 person-years. Multivariable analysis showed higher recurrence risk for males (aHR:1.30, 95%CI: 1.07–1.57), age ≥60 (aHR:1.32, 95%CI: 1.04–1.68), and industrial activity (aHR:1.41, 95%CI: 1.10–1.80). Non-urgency cases (aHR:3.32, 95%CI: 1.49–7.42), visits to larger (M2 versus F2) hospitals (aHR:2.98, 95%CI: 1.43–6.20) and outpatient department (aHR:1.43, 95%CI: 1.18–1.74) compared to the emergency department were also linked to higher recurrence.

Conclusion

The findings highlight a substantial incidence of recurrent ocular injuries in rural Thailand, predominantly affecting males and older adults, particularly in industrial sectors. Targeted public health interventions are necessary to enhance injury prevention strategies.