Trobisch P D, Ricart P, Bharucha N
Orthopädische Klinik Berlin im Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, Berlin.
Z Orthop Unfall. 2012 Feb;150(1):48-51. doi: 10.1055/s-0031-1280112. Epub 2011 Oct 12.
Low follow-up rates are a limitation of many long-term studies. Studies on patients after surgical treatment of adolescent idiopathic scoliosis (AIS) rarely have follow-up rates that reach 80% after 5 years or 70% after 10 years. While there is general consensus that a high patient drop-out rate will decrease the accuracy of a study, little is known about the characteristics of those patients who have dropped out. The purpose of the present study was to identify patients who were lost to follow-up after surgical correction of AIS and to compare their clinical characteristics to those of patients who were available for follow-up.
All members of a popular scoliosis-specific online community were asked to submit information about demographic, surgical, and clinical characteristics. Patients who had surgical treatment for AIS and a minimum of 12 months since surgery were grouped into "lost to follow-up - LTF" and "follow-up - FU" based on whether they had changed their orthopedist or not after surgery. Demographic, surgical, and clinical characteristics with the use of the SRS-22 instrument were then compared.
271 patients submitted information of whom 81 patients (39 FU, 42 LTF) fulfilled all inclusion criteria. No difference was found in terms of age at surgery, surgical approach, number of fused levels, or revision rate whereas major curve correction and time since surgery showed significant differences. A subanalysis that was done after matching patients for time since surgery revealed significant differences for the SRS-22 domains function, pain, mental health, and total score in favour of the FU group.
We found significant clinical differences for patients who are lost to follow-up when compared to patients who are available for follow-up. While we are aware of the difficulties in obtaining high follow-up rates for a clinical study, care should be taken in analysing studies with low follow-up rates because results may be skewed.
低随访率是许多长期研究的一个局限性。关于青少年特发性脊柱侧凸（AIS）手术治疗后患者的研究，很少有随访率在5年后达到80%或10年后达到70%的情况。虽然人们普遍认为高患者脱落率会降低研究的准确性，但对于那些脱落患者的特征却知之甚少。本研究的目的是识别AIS手术矫正后失访的患者，并将他们的临床特征与可进行随访的患者进行比较。
一个热门的脊柱侧凸特定在线社区的所有成员被要求提交有关人口统计学、手术和临床特征的信息。接受AIS手术治疗且术后至少12个月的患者，根据术后是否更换骨科医生，分为“失访-LTF”组和“随访-FU”组。然后比较使用SRS-22工具得出的人口统计学、手术和临床特征。
271名患者提交了信息，其中81名患者（39名FU，42名LTF）符合所有纳入标准。在手术年龄、手术方式、融合节段数量或翻修率方面未发现差异，而主弯矫正和术后时间显示出显著差异。在对患者术后时间进行匹配后进行的亚分析显示，SRS-22领域的功能、疼痛、心理健康和总分在FU组方面存在显著差异。
我们发现，与可进行随访的患者相比，失访患者存在显著的临床差异。虽然我们意识到在临床研究中获得高随访率存在困难，但在分析随访率低的研究时应谨慎，因为结果可能会有偏差。
