The lost to trauma patient follow-up

Aaland, Mary Oline; Marose, Kyle; Zhu, Thein Hlaing

doi:10.1097/ta.0b013e31826fc928

Cited by 64 publications

(58 citation statements)

References 5 publications

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“…Moreover, we found that poor follow-up compliance persisted across much of the demographic subgroups with no one subgroup having a compliance follow-up rate greater than 41%. This disquieting compliance rate is significantly lower than the 60% compliance rate required for trauma outcomes research as suggested in the study by Leukhardt et al 8 In a recent study, Aaland et al 14 reported an impressive 79.3% trauma clinic compliance rate and challenged the belief that trauma patients are noncompliant with follow-up. However, the Aaland et al 14 study was conducted at a Level II trauma center in a suburban community, whereas the present study is set in a population dense urban area with more than five times the population size of the study setting of Aaland et al 14 Moreover, the study of Aaland et al 14 did not specifically look at race and insurance status.…”

Section: Discussionmentioning

confidence: 91%

Factors associated with trauma clinic follow-up compliance after discharge

Stone

Marsh

Cucuzzo

et al. 2014

Journal of Trauma and Acute Care Surgery

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BACKGROUND:Disparities in access to postdischarge services for trauma patients exist, and clinic follow-up remains an important avenue to ensure initial and continued access to postdischarge services. In addition, follow-up is vital to rigorous long-term trauma outcomes research. However, there is a relative paucity of literature specifically addressing clinic follow-up. The purposes of this study were to elucidate factors associated with clinic follow-up compliance and noncompliance after discharge from an urban Level I trauma center and to confirm the prevailing notion that follow-up in trauma clinic is poor. METHODS:Our trauma registry was queried for all trauma service discharges of patients 18 years and older for a 2-year period. Patients with incomplete information were excluded. Demographic data such as race/ethnicity and insurance status were collected on all patients. Primary outcome was defined as trauma clinic follow-up within 4 weeks after discharge. Patients compliant with follow-up were compared with noncompliant patients. RESULTS:After exclusion criteria were applied, there were 1,818 discharges included in the analysis, with 564 (31%) complying with follow-up (p G 0.001). Factors significantly associated with follow-up noncompliance included patients older than 35 years, white race, Medicaid/Medicare payers, blunt mechanism, extended hospital length of stay, and discharge to rehabilitation facilities. No insurance, penetrating mechanism, short hospital stay, discharge to home, and weekend discharge were all significantly associated with follow-up compliance. Discharge on weekends and to home were independent predictors of compliance, whereas, Medicaid/Medicare insurance status and operative intervention were independent predictors of noncompliance. CONCLUSION:This study indentifies factors associated with trauma clinic follow-up compliance and confirms the notion that trauma clinic follow-up compliance at an urban Level I trauma center is alarmingly low. These findings may serve as targets to improve follow-up, thereby improving trauma outcomes research and long-term outcomes. Consequently, clinic follow-up compliance warrants further study and consideration as an essential trauma registry datum. (J Trauma Acute Care Surg. 2014;76: 185Y190.

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Section: Discussionmentioning

confidence: 91%

Factors associated with trauma clinic follow-up compliance after discharge

Stone

Marsh

Cucuzzo

et al. 2014

Journal of Trauma and Acute Care Surgery

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“…Fisker et al [34], Joe et al [35], and Hu et al [36] reported similar observations to those in the present study. There are few studies with postoperative follow-up in trauma patients [37][38][39]. We had a follow-up of 62% of patients at the end of three months, and patients reported good pain relief and PSS.…”

Section: Discussionmentioning

confidence: 98%

Role of dexmedetomidine as adjuvant in postoperative sciatic popliteal and adductor canal analgesia in trauma patients: a randomized controlled trial

et al. 2020

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Background: The effect of dexmedetomidine as an adjuvant in the adductor canal block (ACB) and sciatic popliteal block (SPB) on the postoperative tramadol-sparing effect following spinal anesthesia has not been evaluated. Methods: In this randomized, placebo-controlled study, ninety patients undergoing below knee trauma surgery were randomized to either the control group, using ropivacaine in the ACB + SPB; the block Dex group, using dexmedetomidine + ropivacaine in the ACB + SPB; or the systemic Dex group, using ropivacaine in the ACB + SPB + intravenous dexmedetomidine. The primary outcome was a comparison of postoperative cumulative tramadol patient-controlled analgesia (PCA) consumption at 48 hours. Secondary outcomes included time to first PCA bolus, pain score, neurological assessment, sedation score, and adverse effects at 0, 5, 10, 15, and 60 minutes, as well as 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after the block. Results: The mean ± standard deviation of cumulative tramadol consumption at 48 hours was 64.83 ± 51.17 mg in the control group and 41.33 ± 38.57 mg in the block Dex group (P = 0.008), using Mann-Whitney U-test. Time to first tramadol PCA bolus was earlier in the control group versus the block Dex group (P = 0.04). Other secondary outcomes were comparable. Conclusions: Postoperative tramadol consumption was reduced at 48 hours in patients receiving perineural or systemic dexmedetomidine with ACB and SPB in below knee trauma surgery.

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“…the trauma population is demonstrated by our lost to followup rate of 22.2%, higher than previously reported rates of 10.8%. 9 Despite our dedicated LCS, previously suggested as a targeted patient-retention strategy, 2,10 further strategies are needed.…”

Section: Discussionmentioning

confidence: 99%