Long-term workload, changing injury patterns, and spring festival-related case mix among patients hospitalized with open globe injury at a Chinese tertiary referral centre, 2013–2025

Abstract

Abstract Background Open globe injury (OGI) is vision-threatening, but long-term changes in hospitalized workload and injury patterns remain poorly characterized. We assessed temporal changes in OGI workload and relative inpatient burden and whether the Spring Festival was associated with excess admissions or short-window differences in injury composition. Methods We retrospectively analyzed 1,096 unique patients, each contributing one index hospitalization for traumatic OGI requiring inpatient management at a tertiary referral centre in China from 2013 to 2025. Poisson models assessed monthly OGI workload and relative inpatient burden, with monthly ophthalmic admissions included as an offset. Spring Festival analyses compared Lunar New Year ± 7 days with nonwindow days within the same ± 30-day envelope. Firework-related composition was assessed among patients hospitalized within 24 h after injury, and injury-setting trends were evaluated using multinomial logistic regression. Results Among 1,096 patients, 1,070 (97.6%) underwent surgery at the study hospital. Monthly OGI workload increased over time (IRR per year, 1.06; 95% CI, 1.04–1.08; P < 0.001), whereas relative inpatient burden declined (IRR per year, 0.97; 95% CI, 0.95–0.99; P = 0.003). The Spring Festival window was not associated with clear excess daily admissions (IRR, 0.66; 95% CI, 0.43–1.02; P = 0.062). Firework-related injury was more frequent during the festival window (31.8% [7/22] vs. 3.4% [3/87]; OR, 13.07; 95% CI, 3.04–56.25; P < 0.001), although based on only 10 events. Agricultural injury increased relative to industrial injury in the primary model (RRR per year, 1.14; 95% CI, 1.03–1.25; P = 0.009), but the estimate was attenuated after adjustment for age and sex, with little further change after adding direct-admission status. Conclusions Hospitalized OGI workload increased while relative inpatient burden declined, but these hospital-level trends do not establish regional incidence. The Spring Festival was associated with a higher proportion of firework-related cases without clear excess admission volume. Injury-setting changes were modest, and industrial injury remained dominant. These findings may inform local ocular trauma prevention and ophthalmic emergency service planning.