Participant retention in trauma intensive care unit (ICU) follow-up studies: a post-hoc analysis of a previous scoping review

Abstract

BackgroundThe study aimed to synthesize participant retention-related data for longitudinal follow-up studies of survivors from trauma intensive care units (ICUs).MethodsWithin a published scoping review evaluating ICU patient outcomes after hospital discharge, two screeners independently searched for trauma ICU survivorship studies.ResultsThere were 11 trauma ICU follow-up studies, all of which were cohort studies. Twelve months (range: 1–60 months) was the most frequent follow-up time point for assessment (63% of studies). Retention rates ranged from 54% to 94% across time points and could not be calculated for two studies (18%). Pooled retention rates at 3, 6, and 12 months were 75%, 81%, and 81%, respectively. Mean patient age (OR 0.85 per 1-year increase, 95% CI 0.73 to 0.99, p=0.036), percent of men (OR 1.07, 95% CI 1.04 to 1.10, p=0.002), and publication year (OR 0.89 per 1-year increase, 95% CI 0.82 to 0.95, p=0.007) were associated with retention rates. Early (3-month) versus later (6-month, 12-month) follow-up time point was not associated with retention rates.DiscussionPooled retention rates were >75%, at 3-month, 6-month, and 12-month time points, with wide variability across studies and time points. There was little consistency with reporting participant retention methodology and related data. More detailed reporting guidelines, with better author adherence, will help improve reporting of participant retention data. Utilization of existing research resources may help improve participant retention.Level of evidenceLevel III: meta-analyses (post-hoc analyses) of a prior scoping review.

Follow-up of severely injured patients can be embedded in routine hospital care: results from a feasibility study

“…Determinants of complete follow-up at 6 and 12 months in our program were older age (65+ years) and longer length of stay (> 7 days) respectively. Whilst our follow-up rates at 6 and 12-months were in the range reported by others (54% to 94%) [39], evidence suggests they decrease after 12 months. Accordingly, there may be value in examining whether incorporating an acceptable and convenient service delivery activity such as referral to telehealth rehabilitation consults [40] could improve patient adherence to hospital follow-up.…”

Barriers and Facilitators to Implementation of a Telephone Follow-Up Program for Severely Injured Trauma Patients – A Process Evaluation

“…Determinants of complete follow-up at 6 and 12 months in our program were older age (65 + years) and longer length of stay (> 7 days) respectively. Whilst our follow-up rates at 6 and 12 months were in the range reported by others (54-94%), [35] evidence from that review shows that they drop after 12 months. Accordingly, there might be value in examining whether incorporating an acceptable and convenient service delivery activity such as referral to telehealth rehabilitation consults [36] could improve patient adherence to hospital follow-up.…”

Developing a National Trauma Research Action Plan: Results from the geriatric research gap Delphi survey

“…30 This is more challenging for retaining patients for postdischarge follow up among trauma intensive care unit. 31 In addition, since older adults have special conditions and needs, researching this population is even more challenging. For instance, older adults often have travel limitations, and this will result in low participation.…”

“…Because of the variability in injury type, severity, and population diversity, it is hard to develop an effective and robust research design 30 . This is more challenging for retaining patients for postdischarge follow up among trauma intensive care unit 31 . In addition, since older adults have special conditions and needs, researching this population is even more challenging.…”