Bennett Desmond J, Bango Jugert, Rothkopf Douglas M
Division of Plastic Surgery, University of Massachusetts Medical School, Worcester, Mass.
Department of Orthopedic Surgery, University of Florida College of Medicine - Jacksonville, Jacksonville, Fla.
Plast Reconstr Surg Glob Open. 2023 Apr 26;11(4):e4941. doi: 10.1097/GOX.0000000000004941. eCollection 2023 Apr.
Postoperative hand therapy (HT) is important for regaining function and preventing complications in patients undergoing tendon repair of the hand and wrist. Loss to follow-up (LTFU) can hinder this process; so we sought to determine factors that predict attrition of these patients.
Charts were retrospectively reviewed for patients who underwent extensor or flexor tendon repair of the hand, wrist, or forearm between 2014 and 2019. Demographic data, including age, sex, zip code, employment status, education level, and insurance type, were collected, and the rate of LTFU was calculated. Logistic regression was used to analyze factors.
A total of 149 patients were identified and analyzed. The rate of LTFU was 42%. Factors that predicted loss were younger age, male gender, lower educational degree, and a documented psychiatric history. Employment status, insurance type, and distance from the HT center did not predict attrition. The number of HT weeks recommended by the occupational therapist did not differ between those who were lost and those who were not. Lost patients completed, on average, 57% of their suggested HT course.
The current study identified demographic factors associated with attrition in patients undergoing tendon repair of the distal upper extremity. Factors included patients who were younger, male gender, less educated, and had a documented psychiatric history. By identifying factors that predict LTFU, specific strategies can be developed to reduce attrition rates, particularly for at-risk populations, to improve patient care after tendon repair.
术后手部治疗（HT）对于手部和腕部肌腱修复患者恢复功能及预防并发症至关重要。失访（LTFU）会阻碍这一进程；因此我们试图确定预测这些患者失访的因素。
对2014年至2019年间接受手部、腕部或前臂伸肌或屈肌肌腱修复的患者病历进行回顾性分析。收集人口统计学数据，包括年龄、性别、邮政编码、就业状况、教育水平和保险类型，并计算失访率。采用逻辑回归分析相关因素。
共确定并分析了149例患者。失访率为42%。预测失访的因素包括年龄较小、男性、教育程度较低以及有精神病史记录。就业状况、保险类型和距手部治疗中心的距离不能预测失访情况。职业治疗师建议的手部治疗周数在失访患者和未失访患者之间并无差异。失访患者平均完成了建议手部治疗课程的57%。
本研究确定了与上肢远端肌腱修复患者失访相关的人口统计学因素。这些因素包括年龄较小、男性、受教育程度较低以及有精神病史记录。通过确定预测失访的因素，可以制定具体策略以降低失访率，尤其是针对高危人群，从而改善肌腱修复后的患者护理。
