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Published in: Archives of Orthopaedic and Trauma Surgery 3/2015

01-03-2015 | Orthopaedic Surgery

What factors influence follow-up in orthopedic trauma surgery?

Authors: Paul S. Whiting, Sarah E. Greenberg, Rachel V. Thakore, Vignesh K. Alamanda, Jesse M. Ehrenfeld, William T. Obremskey, Alex Jahangir, Manish K. Sethi

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2015

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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.
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Metadata
Title
What factors influence follow-up in orthopedic trauma surgery?
Authors
Paul S. Whiting
Sarah E. Greenberg
Rachel V. Thakore
Vignesh K. Alamanda
Jesse M. Ehrenfeld
William T. Obremskey
Alex Jahangir
Manish K. Sethi
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 3/2015
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-015-2151-8

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