Epidemiology and follow-up adherence of ophthalmic emergencies: A 10-year study at a tertiary medical center in Taiwan.

PURPOSE: The purpose of the study was to evaluate factors influencing outpatient follow-up adherence among patients receiving ophthalmology consultations in the emergency department (ED).

MATERIALS AND

METHODS

This retrospective cohort study collected data from the Chang Gung Research Database. Patients who received ophthalmology consultations at the ED of Chang Gung Memorial Hospital Linkou Medical Center from January 1, 2010, to December 31, 2019, were included. Patients were divided into two groups based on whether they completed outpatient follow-up within 28 days, a timeframe consistent with our hospital's scheduling policy. Demographics, ED visit timing, triage categories, ophthalmic diagnoses, prior visits, and ED stay durations were analyzed using logistic regression.

RESULTS

A total of 42,530 patients were included (mean age 38.6 ± 20.2 years; 59.2% male), with 38.4% adhering to follow-up and 61.6% not. Nonadherence was associated with younger age (odds ratio [OR]: 0.92; 95% confidence interval [CI]: 0.92-0.93), evening (OR: 1.28; 95% CI: 1.22-1.34) or midnight (OR: 1.94; 95% CI: 1.83-2.06) ED visits, not likely emergent diagnoses (OR: 2.09; 95% CI: 1.96-2.22), and shorter ED stays (<1 h: OR: 3.73; 95% CI: 3.46-4.03). Patients with prior ophthalmology outpatient visits (OR: 0.48; 95% CI: 0.46-0.52) and longer ED stays (more than 3 h) demonstrated better adherence. Over 10 years, emergent diagnoses increased from 51.1% to 69.5%, while non-emergent diagnoses declined from 23.1% to 13.2%.

CONCLUSION

Adherence to outpatient follow-up after ophthalmic ED visits was low. Younger age, evening or midnight visits, non-emergent diagnoses, and short ED stays predicted non-adherence, whereas prior outpatient visits and longer ED stays improved adherence.