UC Davis School of Medicine, University of California, Davis, Sacramento, USA.
Department of Surgery, Division of Burn Surgery, University of California, Davis, Sacramento, USA.
J Burn Care Res. 2021 Aug 4;42(4):627-632. doi: 10.1093/jbcr/irab065.
For medical and social reasons, it is important that burn patients attend follow-up appointments (FUAs). Our goal was to examine the factors leading to missed FUAs in burn patients. A retrospective chart review was conducted of adult patients admitted to the burn center from 2016 to 2018. Data collected included burn characteristics, social history, and zip code. Data analysis was conducted using chi-square, Wilcoxon Rank-Sum tests, and multivariate regression models. A total of 878 patients were analyzed, with 224 (25.5%) failing to attend any FUAs and 492 (56.0%) missing at least one appointment (MA). Patients who did not attend any FUAs had smaller burns (4.5 [8]% vs 6.5 [11]% median [inter quartile range]), traveled farther (70.2 [111.8] vs 52.5 [76.7] miles), and were more likely to be homeless (22.8% vs 6.9%) and have drug dependence (47.3% vs 27.2%). Patients who had at least one MA were younger (42 [26] vs 46 [28] years) and more likely to be homeless (17.5% vs 2.6%) and have drug dependence (42.5% vs 19.4%). On multivariate analysis, factors associated with never attending an FUA were distance from hospital (odds ratio [OR] 1.004), burn size (OR 0.96), and homelessness (OR 0.33). Factors associated with missing at least one FUA: age (OR 0.99), drug dependence (OR 0.46), homelessness (OR 0.22), and Emergency Department visits (OR 0.56). A high percentage of patients fail to make any appointment following their injury and/or have at least one MA. Both FUAs and MAs are influenced by social determinants of health.
出于医学和社会原因，烧伤患者定期接受随访（FUAs）非常重要。我们的目标是研究导致烧伤患者错过 FUAs 的因素。对 2016 年至 2018 年期间入住烧伤中心的成年患者进行了回顾性图表审查。收集的数据包括烧伤特征、社会史和邮政编码。使用卡方检验、Wilcoxon 秩和检验和多变量回归模型进行数据分析。共分析了 878 例患者，其中 224 例（25.5%）未参加任何 FUAs，492 例（56.0%）至少错过一次预约（MA）。未参加任何 FUAs 的患者烧伤面积较小（4.5 [8]% vs 6.5 [11]%中位数[四分位距]），路程较远（70.2 [111.8] vs 52.5 [76.7]英里），更有可能无家可归（22.8% vs 6.9%）和有药物依赖（47.3% vs 27.2%）。至少有一次 MA 的患者年龄较小（42 [26] vs 46 [28]岁），更有可能无家可归（17.5% vs 2.6%）和有药物依赖（42.5% vs 19.4%）。多变量分析显示，从未参加过 FUA 的相关因素是距离医院的距离（比值比[OR]1.004）、烧伤面积（OR 0.96）和无家可归（OR 0.33）。至少错过一次 FUA 的相关因素：年龄（OR 0.99）、药物依赖（OR 0.46）、无家可归（OR 0.22）和急诊就诊（OR 0.56）。大量患者在受伤后未能预约任何一次就诊，或至少错过了一次 MA。FUAs 和 MAs 均受健康的社会决定因素影响。
