Midwestern University Chicago College of Osteopathic Medicine, Downers Grove, IL.
Department of Nursing Research, UChicago Medicine, Chicago, IL; Department of Surgery, University of Chicago, Chicago, IL.
Ann Vasc Surg. 2024 Aug;105:316-324. doi: 10.1016/j.avsg.2024.01.010. Epub 2024 Apr 10.
It is estimated that 22-57% of vascular patients are lost to follow-up (LTF) which is of concern as the Society of Vascular Surgery recommends annual patient follow-up. The purpose of this report was to identify social determinants of health factors (SDoH) and their relationship to LTF in vascular patients.
The methods employed were a systematic literature review of 29 empirical articles and a retrospective quality improvement report with 27 endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) patients at the University of Chicago.
The systematic literature review resulted in 2,931 articles which were reduced to 29 articles meeting the inclusion criteria. Demographic variables were more frequently cited than SDoH factors, but the most common were smoking, transportation, and socioeconomic status/insurance. Additionally, 176 EVAR and TEVAR patients were called resulting in 27 patients who completed a SDoH questionnaire. Twenty-six percent indicated they had missed at least 1 appointment with the top reasons being work or family responsibilities. Due to limited patient size no statistical analyses were performed, but frequencies of responses to SDoH questions were reported to augment the existing limited literature and guide future research into variables such as one's ability to pay for basics like food or mortgage.
SDoH factors are important yet understudied aspects of endovascular repairs that require more research to understand their impact on vascular surgery follow-up rates and outcomes. Additional research is needed as lack of consideration of such factors may impact the generalizability of existing research and such knowledge may help in informing clinician treatment plans.
据估计，22%-57%的血管患者会失访（LTF），这令人担忧，因为血管外科学会建议患者每年进行随访。本报告的目的是确定健康相关社会决定因素（SDoH）及其与血管患者 LTF 的关系。
采用系统文献回顾 29 篇实证文章和芝加哥大学 27 例血管内主动脉修复（EVAR）和胸主动脉内修复（TEVAR）患者的回顾性质量改进报告。
系统文献回顾共产生 2931 篇文章，最终筛选出符合纳入标准的 29 篇文章。人口统计学变量比 SDoH 因素更常被提及，但最常见的是吸烟、交通和社会经济地位/保险。此外，共随访了 176 例 EVAR 和 TEVAR 患者，其中 27 例患者完成了 SDoH 问卷。26%的患者表示至少错过了一次预约，主要原因是工作或家庭责任。由于患者数量有限，未进行统计学分析，但报告了 SDoH 问题的回答频率，以补充现有有限的文献，并指导未来对支付食物或抵押贷款等基本生活费用能力等变量的研究。
SDoH 因素是血管内修复中重要但研究不足的方面，需要进一步研究以了解它们对血管外科学随访率和结局的影响。需要进一步研究，因为不考虑这些因素可能会影响现有研究的普遍性，而这些知识可能有助于为临床医生的治疗计划提供信息。
