Schexnayder Stuart P, Valentino John L, Leonardi Claudia, Bronstone Amy B, Dasa Vinod
Orthopedics. 2023 Mar-Apr;46(2):93-97. doi: 10.3928/01477447-20221129-04. Epub 2022 Dec 2.
Despite increased pressure to capture patient-reported outcome measures for at least 1 year following total joint arthroplasty (TJA), follow-up rates during the first year after TJA are typically lower than desired and may result in biased findings if data are not missing at random. We conducted a retrospective review of medical records of primary total knee arthroplasty patients treated by a single surgeon at an urban academic private hospital. Main measures were demographics (sex, age, race, and insurance), body mass index, travel distance to clinic, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Multivariable regression analyses were performed to identify patient characteristics associated with attendance at follow-up visits and predictors of attendance at 6-month follow-up. Among the 205 study patients, follow-up visit attendance declined from a high of 95.7% at day 14 to lows of 69.2% at 6 months and 64.4% at 1 year. Attendance at the previously scheduled follow-up visit was a statistically significant predictor of attendance at 3-month (=.0015), 6-month (=.0002), and 1-year (<.0001) follow-up visits, and travel distance was significantly associated with attending the 1-year follow-up visit (=.042). Patients with the most favorable KOOS Symptom, Pain, and Function in daily living subscale scores at 3-month follow-up were significantly less likely to attend the 6-month follow-up visit than patients with the least favorable KOOS scores. Prospective studies are needed to identify the full range of factors that may contribute to high rates of loss to follow-up after TJA, which should be of concern to researchers, clinicians, and hospitals. [. 2023;46(2):93-97.].
尽管在全关节置换术(TJA)后至少1年收集患者报告的结局指标的压力不断增加,但TJA后第一年的随访率通常低于预期,如果数据并非随机缺失,可能会导致有偏差的结果。我们对一家城市学术私立医院的一名外科医生治疗的初次全膝关节置换术患者的病历进行了回顾性研究。主要指标包括人口统计学特征(性别、年龄、种族和保险类型)、体重指数、到诊所的距离以及膝关节损伤和骨关节炎结局评分(KOOS)。进行多变量回归分析以确定与随访就诊相关的患者特征以及6个月随访的就诊预测因素。在205名研究患者中,随访就诊率从第14天的95.7%的高位下降到6个月时的69.2%和1年时的64.4%的低位。按计划进行的前次随访就诊是3个月(P =.0015)、6个月(P =.0002)和1年(P <.0001)随访就诊的统计学显著预测因素,且到诊所的距离与1年随访就诊显著相关(P =.042)。在3个月随访时KOOS症状、疼痛和日常生活功能子量表评分最有利的患者比KOOS评分最不利的患者参加6个月随访就诊的可能性显著降低。需要进行前瞻性研究以确定可能导致TJA后高失访率的所有因素,这应引起研究人员、临床医生和医院的关注。[. 2023;46(2):93 - 97.]