title: Distance to clinic and follow-up visit compliance in adolescent gastric bypass cohort.
abstract: BACKGROUND
  Regular follow-up after bariatric surgery is important to assess the clinical status. Various factors could influence retention (i.e., compliance with clinical follow-up). The present analysis tested the hypothesis that the distance from the center will influence clinical retention for adolescent bariatric surgery patients. Our aim was to determine whether the distance to the clinic, and other patient characteristics, would predict clinical follow-up compliance. The present study was conducted at a tertiary care, free-standing children's hospital.
  
  
  METHODS
  The Follow-up of Adolescent Bariatric Surgery (FABS) study is a single-center cohort study collecting demographic and clinical information. The subjects' addresses were geocoded, and the distance to the clinic was calculated. A generalized estimating equations model was used to examine follow-up visit compliance.
  
  
  RESULTS
  A total of 71 subjects underwent Roux-en-Y gastric bypass surgery (RYGB), with a mean body mass index of 59 kg/m(2). The average distance to the clinic was 98 miles. Retention declined over time (6 mo, 94%; 1 yr, 89%; 2 yr, 69%; P < .01); however, distance was not associated with retention (P = .68). Age at surgery was inversely related to retention (P = .04).
  
  
  CONCLUSIONS
  Compliance with clinical follow-up decreased 1 and 2 years after RYGB in adolescents. The distance from the center was not associated with follow-up regimen compliance. However, increasing age was associated with decreased retention. Additional research should focus on determining the modifiable factors that influence retention.
authors.affiliation: Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. todd.jenkins@cchmc.org
authors.forename: Todd M
authors.initials: TM
authors.lastname: Jenkins
authors.forename: Stavra A
authors.initials: SA
authors.lastname: Xanthakos
authors.forename: Meg H
authors.initials: MH
authors.lastname: Zeller
authors.forename: Sean J
authors.initials: SJ
authors.lastname: Barnett
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
mesh_terms: D000293:Adolescent; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D015390:Gastric Bypass; D040362:Geographic Information Systems; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010349:Patient Compliance; D014195:Travel; D055815:Young Adult