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Loss of Follow-up in Orthopaedic Trauma: Who Is Getting Lost to Follow-up?

Zelle, Boris A. MD*; Buttacavoli, Frank A. MD*; Shroff, Jeffrey B. BS*; Stirton, Jacob B. MD

doi: 10.1097/BOT.0000000000000346
Original Article
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Objectives: Noncompliance with postoperative follow-up visits remains a common problem in orthopaedic trauma. The aim of this study was to identify risk factors for loss of follow-up after orthopaedic trauma.

Design: Retrospective review.

Setting: Urban level 1 academic trauma center.

Patients: A total of 307 (226 men/81 women) patients undergoing surgical treatment of their orthopaedic injuries were included in this study. The average age was 40.4 ± 17 years.

Intervention: All patients were treated surgically for their orthopaedic injuries and were instructed to follow-up in the orthopaedic trauma clinic after hospital discharge.

Main Outcome Measurements: Noncompliance with follow-up appointment at 6 months after injury.

Results: Over a 6-month postoperative period, a total of 215 patients were noncompliant with at least one of their follow-up appointments between hospital discharge and the 6-month follow-up. A logistic regression showed male gender, uninsured or government insurance, and smoker to be statistically significant risk factors for noncompliance with the 6-month follow-up (P < 0.05). Noncompliance with any follow-up appointment was significantly increased in patients with illicit drug abuse (P = 0.02) as per logistic regression analysis.

Conclusions: Loss of follow-up is a common problem in orthopaedic trauma. Our study suggests different risk factors for noncompliance, including male gender, smoker, lack of commercial health insurance, and illicit drug abuse. Health care providers may consider establishing protocols for facilitating follow-up appointments to patients who are at risk for noncompliance.

Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

*Division of Orthopaedic Traumatology, Department of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX; and

Department of Orthopaedic Surgery, University of Toledo, Toledo, OH.

Reprints: Boris A. Zelle, MD, Division of Orthopaedic Traumatology, Department of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7774, San Antonio, TX 78229 (e-mail: zelle@uthscsa.edu).

The authors report no conflict of interest.

Accepted March 30, 2015

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