title: Loss of Follow-up in Orthopaedic Trauma: Who Is Getting Lost to Follow-up?
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Urban level 1 academic trauma center.
  
  
  METHODS
  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.
  
  
  METHODS
  All patients were treated surgically for their orthopaedic injuries and were instructed to follow-up in the orthopaedic trauma clinic after hospital discharge.
  
  
  METHODS
  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.
authors: *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.
authors: Boris A
authors: BA
authors: Zelle
authors: Frank A
authors: FA
authors: Buttacavoli
authors: Jeffrey B
authors: JB
authors: Shroff
authors: Jacob B
authors: JB
authors: Stirton
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001850:Bone Diseases, Infectious / Q000601:surgery; D003710:Demography; D005260:Female; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000601:surgery; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D017695:Soft Tissue Injuries / Q000601:surgery; D014193:Trauma Centers / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000601:surgery / Q000628:therapy*; D055815:Young Adult