The Association Between Sociodemographic Factors, Common XXXX , and Keratoconus: An Analysis of a Nationwide Heath Care Claims Database.

@entity1 @entity308 @entity339 @entity2023 @entity387 @entity6 @entity449 @entity565 @entity262 @entity1413
PURPOSE: The purpose of this study was to determine whether an association exists between common @entity262 , sociodemographic factors, and keratoconus (KCN) among a large, diverse group of insured individuals in the United States. DESIGN: Retrospective longitudinal cohort study. @entity1 : Sixteen thousand fifty-three @entity1 with KCN were matched 1:1 with @entity1 without KCN. METHODS: @entity1 with KCN were identified using billing codes and matched by age, gender, and overall health with a control group with no record of KCN. Multivariable logistic regression assessed whether sociodemographic factors and certain @entity262 affected the odds of KCN. MAIN OUTCOME MEASURES: Odds ratios (ORs) with 95% confidence intervals (CIs) of receiving a KCN diagnosis. RESULTS: After adjustment for confounders, black @entity1 had 57% higher odds (adjusted OR, 1.57; 95% CI, 1.38-1.79; P < 0.001) and Latino @entity1 had 43% higher odds (adjusted OR, 1.43; 95% CI, 1.26-1.62; P  < 0.001) of being diagnosed with KCN compared with whites. Asians had 39% reduced odds (adjusted OR, 0.61; 95% CI, 0.50-0.75; P < 0.001) of being diagnosed with KCN compared with whites. @entity1 with uncomplicated @entity6 ( @entity6 ) had 20% lower odds of KCN (adjusted OR, 0.80; 95% CI, 0.71-0.90; P  =  0.002), and @entity1 with @entity6 complicated by end-organ damage had 52% lower odds of having KCN (adjusted OR, 0.48; 95% CI, 0.40-0.58; P < 0.001) compared with those without @entity6 . @entity1 with @entity1413 had 35% lower odds of KCN (adjusted OR, 0.65; 95% CI, 0.47-0.91; P  = 0.01). Other conditions found to have increased odds of KCN included @entity387 (adjusted OR, 1.13; 95% CI, 1.00-1.27; P  = 0.05), @entity565 (adjusted OR, 1.31; 95% CI, 1.17-1.47; P < 0.001), and Down syndrome (adjusted OR, 6.22; 95% CI, 2.08-18.66; P < 0.001). There was no association between KCN and @entity2023 , @entity339 , @entity449 , or @entity308 (P > 0.1 for all comparisons). CONCLUSIONS: Clinicians caring for @entity1 with KCN should inquire about breathing or sleeping and, when appropriate, refer @entity1 for evaluation for @entity387 or @entity565 . @entity1 with @entity6 have lower risk of KCN, potentially because of corneal glycosylation.
