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骨科创伤手术随访评估及常规回访计划的影响

Evaluation of Orthopedic Trauma Surgery Follow-up and Impact of a Routine Callback Program.

作者信息

Casp Aaron J, Wells Jodi, Holzgrefe Russell, Weiss David, Kahler David, Yarboro Seth R

出版信息

Orthopedics. 2017 Mar 1;40(2):e312-e316. doi: 10.3928/01477447-20161229-01. Epub 2017 Jan 6.

Abstract

A high rate of patients lost to follow-up is a common problem in orthopedic trauma surgery. This adversely affects the ability to produce accurate clinical outcomes research. The purpose of this project was to (1) evaluate the rate of loss to follow-up at an academic level I trauma center; (2) identify the patient-reported reasons for loss to follow-up; and (3) evaluate the efficacy of a routine patient callback program. All patients who underwent surgery in the orthopedic trauma division of the University of Virginia Medical Center from April 1, 2014, to September 30, 2014, and did not complete their postoperative clinic follow-up were analyzed. The characteristics of these patients were evaluated, and the primary reason for not completing the recommended follow-up was identified. All patients were then offered additional orthopedic follow-up at the time of contact. Of the 480 patients who met the inclusion criteria, 41 (8.5%) failed to complete the recommended postoperative follow-up course. The most common reason for being lost to follow-up was feeling well and not having the need to be seen (46.3%). Only 6 (14.6%) of the 41 patients requested follow-up care at the time of contact. The lost to follow-up rate in this study, 8.5%, was considerably lower than that previously reported, but patient characteristics were consistent with those of prior studies on this subject. The low lost to follow-up rate may reflect a difference in geographic location or patient population. The patient callback program had a low yield of patients requesting additional follow-up after being contacted. [Orthopedics. 2017; 40(2):e312-e316.].

摘要

在骨科创伤手术中,高失访率是一个常见问题。这对开展准确的临床疗效研究的能力产生不利影响。本项目的目的是:(1)评估一级学术创伤中心的失访率;(2)确定患者报告的失访原因;(3)评估常规患者回访计划的效果。对2014年4月1日至2014年9月30日在弗吉尼亚大学医学中心骨科创伤科接受手术且未完成术后门诊随访的所有患者进行分析。评估这些患者的特征,确定未完成推荐随访的主要原因。然后在联系所有患者时为其提供额外的骨科随访。在符合纳入标准的480例患者中,41例(8.5%)未完成推荐的术后随访疗程。失访的最常见原因是感觉良好且无需就诊(46.3%)。41例患者中只有6例(14.6%)在联系时要求进行随访护理。本研究中的失访率为8.5%,远低于先前报道的失访率,但患者特征与此前关于该主题的研究一致。低失访率可能反映了地理位置或患者群体的差异。患者回访计划在联系后要求额外随访的患者中收效甚微。[《骨科》。2017年;40(2):e312 - e316。]

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