OTA 2008 Posters

Scientific Poster #113 Upper Extremity OTA-2008

Who is Lost to Follow-up? A Study of Patients with Distal Radius Fractures

Nirmal C. Tejwani, MD (a,b-Biomet; b-Stryker, Zimmer); Gopi Nayak (n); Brian Pahk (n);
Kenneth A. Egol, MD (a-Smith + Nephew, Stryker, Synthes; a,b-Biomet; b-Exactech, Inc;
d-Johnson & Johnson);
NYU Hospital for Joint Diseases, New York, New York, USA

Introduction: Outcome studies for fracture patients have reported loss of follow-up of up to 50%. This is multifactorial; however, factors associated or responsible for this lack of follow- up have not been assessed in detail in the orthopaedic literature. The purpose of this study is to identify clinical and demographic factors that characterize patients who are lost to follow-up, as well as to assess underlying causes for poor rates of follow-up.

Methods: After IRB approval, a database was established to enroll all patients treated for distal radius fractures at our institution. Of the 337 patients enrolled, 49 patients were identified as having no follow-up after the initial treatment. A matched cohort of 52 patients with a minimum of 6 months follow-up was identified from the database. Sociodemographic and injury-related data of these 101 patients were collected and compared.

Results: The patients were evenly matched in the two groups with regard to age and sex. Patients were more likely to follow up if treated operatively (65% vs 35%; P = 0.059), if they injured the dominant hand (55% vs 38%; P = 0.03), those with a higher average education (P = 0.001), and those with higher income (P <0.001). There was no difference based on age, sex, marital status, or employment status.

Conclusions: Identifying factors that lead to loss of follow-up is important in directing efforts needed to improve the follow-up in patients treated. This is useful in the trauma setting, where a follow-up of 60% to 70% is not unusual. If these patients are identified early, extra effort can be made in ensuring the return of these patients to the treating hospital and physicians. This in turn will improve patient compliance, prevent complications due to lack of follow-up, and allow more accurate assessment of results and thereby improve outcomes.

If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.