Faculty Collaboration Database

What factors influence follow-up in orthopedic trauma surgery? Arch Orthop Trauma Surg 2015 Mar;135(3):321-7

Date

01/27/2015

Pubmed ID

25617213

DOI

10.1007/s00402-015-2151-8

Scopus ID

2-s2.0-84925500748 (requires institutional sign-in at Scopus site)   74 Citations

Abstract

BACKGROUND: Among surgical patients, follow-up visits are essential for monitoring post-operative recovery and determining ongoing treatment plans. Non-adherence to clinic follow-up appointments has been associated with poorer outcomes in many different patient populations. We sought to identify factors associated with non-attendance at follow-up appointments for orthopedic trauma patients.

MATERIALS AND METHODS: A retrospective chart review at a level I trauma center identified 2,165 patients who underwent orthopedic trauma surgery from 2008 to 2009. Demographic data including age, sex, race, tobacco use, American Society of Anesthesiologist (ASA) score, insurance status, distance from the hospital, and follow-up time were collected. Injury characteristics including fracture type, anatomic location of the operation, length of hospital stay, living situation and employment status were recorded. Attendance at the first scheduled follow-up visit was recorded. Multivariable log-binomial regression analyses were used with statistical significance maintained at p < 0.05.

RESULTS: Of the 2,165 patients included in the analysis, 1,449 (66.9 %) attended their first scheduled post-operative clinic visit. 33.1 % (717) were not compliant with keeping their first clinic appointment after surgery. Patients who used tobacco, lived more than 100 miles from the clinic site, did not have private insurance, had an ASA score >2, or had a fracture of the hip or pelvis were significantly less likely to follow-up. Age, sex, and race were not significantly associated with failure to follow-up.

DISCUSSION: Follow-up appointments are essential for preventing complications among orthopedic trauma patients. By identifying patients at risk of failure to follow-up, orthopedic surgeons can appropriately design and implement long-term treatment plans specifically targeted for high-risk patients.

Author List

Whiting PS, Greenberg SE, Thakore RV, Alamanda VK, Ehrenfeld JM, Obremskey WT, Jahangir A, Sethi MK

Author

Jesse Ehrenfeld MD, MPH Sr Associate Dean, Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Appointments and Schedules
Continuity of Patient Care
Female
Humans
Male
Middle Aged
Musculoskeletal System
Office Visits
Orthopedic Procedures
Patient Compliance
Retrospective Studies
Tennessee
Trauma Centers