National Trends, Predictors, Healthcare Utilization, and Disparities of Post-Traumatic Endophthalmitis Following Open Globe Injury: A Nationwide Analysis of the National Inpatient Sample, 2016–2022

Background Post‑traumatic endophthalmitis (PTE) is a rare but vision‑threatening complication of open globe injury (OGI). Data on incidence, risk factors, and healthcare utilization at the population level are still scarce. This study evaluates national trends, predictors, and outcomes of PTE after OGI in the United States from 2016 to 2022.Methods We analyzed the National Inpatient Sample (NIS), including all acute OGI admissions with a primary diagnosis or globe-repair procedure. PTE was defined with ICD-10-CM diagnosis codes. We used survey-weighted logistic and log-linear regression to assess healthcare utilization outcomes. We used joinpoint regression to assess temporal trends. Stratified models assessed pediatric vs adult risk profiles.Results Among 4,691 OGI admissions (weighted estimate, 23,455), 93 patients (1.98%) developed PTE. The strongest positive predictors were corneal ulcer (OR 17.81, 95% CI 8.96–33.81) and retinal detachment (OR 2.93, 95% CI 1.38–5.65), while rupture (OR 0.31), avulsion (OR 0.05), and orbital floor fracture (OR 0.03) were associated with lower odds of PTE. PTE was not associated with increased in-hospital mortality (0% vs 0.85%) but was associated with increased length of hospital stay (adjusted geometric mean ratio 1.42, 95% CI 1.18–1.71). Incidence was stable from 2016 to 2022 (APC +5.86%, p = 0.372).Conclusion PTE after OGI is rare but results in a prolonged hospital stay. Corneal ulceration and retinal detachment are key risk factors, and age modifies the impact of IOFB. These findings inform risk stratification, resource allocation, and targeted interventions for the prevention of visual morbidity in ocular trauma patients.