title: Factors predictive of poor compliance with follow-up care after facial trauma: a prospective study.
abstract: We performed a prospective study of 59 consecutive patients with facial trauma who were treated at an urban public hospital. We obtained demographic and clinical data before treatment, then recorded compliance with clinic follow-up care. As expected, young, minority male patients, victims of assault, and blunt mechanisms of injury predominated in our series, and midface fractures and soft tissue injuries were most commonly seen. Thirty-one (52%) patients were admitted, and 28 (48%) were treated as outpatients. Although 66% of patients kept their initial follow-up appointment, only 46% of patients were seen to completion of the follow-up period. We used univariate and multivariate analyses to identify factors predictive of poor compliance with follow-up care. Factors predictive of poor compliance with the initial follow-up appointment identified in the multivariate analysis were orbital injury site (p < 0.001), Caucasian race (p = 0.007), and not having a telephone at home (p = 0.043). Factors predictive of poor compliance with completion of follow-up were failure to keep initial appointment (p < 0.001), and treatment with observation, suture only, or open reduction internal fixation only (p = 0.018). Age, marital status, employment status, education level, and hospital admission of the patient were not predictive of compliance with follow-up care. Because compliance with follow-up care may be poor, patients with facial trauma should be managed aggressively initially. In particular, patients with orbital fractures, and those treated with watchful waiting only may have poorer long-term compliance with follow-up care.
authors.affiliation: Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Stewart
authors.forename: A Y
authors.initials: AY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000523:psychology*; D000704:Analysis of Variance; D002648:Child; D005151:Facial Injuries / Q000628:therapy*; D005260:Female; D006779:Hospitals, Public; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008913:Minority Groups; D010349:Patient Compliance; D011237:Predictive Value of Tests; D011446:Prospective Studies; D044469:Racial Groups; D012307:Risk Factors; D017678:Sex Distribution; D013689:Telephone