@article{ref1,
title="The fallacy of follow-up: when orthopaedic trauma patients actually return to  clinic",
journal="Journal of bone and joint surgery: American volume",
year="2020",
author="Agel, Julie and Robertson, Aaron J. and Novak, Avrey A. and Hebert-Davies, Jonah and Kleweno, Conor P.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Clinical follow-up in orthopaedic trauma is challenging, yet  expectations exist that a 1-year follow-up is the minimum requirement for clinical  trials and research publications. The primary purpose of our study was to evaluate  the rate of follow-up after operative orthopaedic trauma care and the relationship  to clinical care. Our secondary aim was to identify any independent risk factors  regarding follow-up completion. <br><br>METHODS: A chart review of patients operatively  treated for a traumatic injury during the months of January and July 2016 was  conducted. Patient demographic characteristics, injury type, severity, and patient  distance from the hospital were collected. The final clinical instructions and  whether a return visit was requested or as needed were recorded. <br><br>RESULTS: There were  293 patients in this study, of whom 84 (29%) had follow-up of at least 1 year and 52  (18%) were instructed to follow up only as needed at their last visit prior to the  1-year mark. When removing the latter 52 patients, the 1-year follow-up rate was 35%  (84 of 241 patients). Of these 241 patients, 157 (65%) were requested to return for  additional clinical care but failed to return prior to 1 year. Logistic regression  identified tobacco use (odds ratio [OR], 0.34 [95% confidence interval (CI), 0.15 to  0.77]; p = 0.010), final appointment status (OR, 6.3 [95% CI, 3.4 to 11.6]; p <  0.001), isolated compared with multiple fractures (OR, 2.2 [95% CI, 1.2 to 4.1]; p =  0.013), and distance from the trauma center per mile as a continuous variable (OR,  0.999 [95% CI, 0.998 to 1.0]; p = 0.03) as significant predictors. <br><br>CONCLUSIONS: Our  data suggest that a 1-year clinic follow-up requirement may not be feasible. We  observed a low rate of patients with a minimum 1-year clinical follow-up. Clinical  care had been completed in 18% of patients prior to 1 year. Journal and grant  reviewers may need to consider the feasibility and clinical relevance of these  follow-up expectations.<p /> <p>Language: en</p>",
language="en",
issn="0021-9355",
doi="10.2106/JBJS.20.00348",
url="http://dx.doi.org/10.2106/JBJS.20.00348"
}