Loyd Nathaniel Grey, Hsiou David, Martinez Armando, Coello Pablo, Pang Lon Kai, Shamim Muhammad Hamza, McGraw-Heinrich Jessica, Rosenfeld Scott B
Department of Orthopaedics, Baylor College of Medicine, Houston, TX, USA.
Department of Orthopaedics, Texas Children's Hospital, Houston, TX, USA.
J Pediatr Soc North Am. 2024 Jun 26;8:100073. doi: 10.1016/j.jposna.2024.100073. eCollection 2024 Aug.
This study seeks to analyze risk factors associated with loss to follow up (LTF) after pin pull in pediatric patients with operatively treated supracondylar humerus fractures (SCHF).
A retrospective cohort study of patients under 18 years with operative SCHF from 2010 to 2020 was conducted. Factors of interest included LTF, age, race, language, distance to the hospital, Gartland fracture type, and Social Deprivation Index (SDI) by ZIP code. Univariate logistic regression was performed for each independent variable and significant variables were additionally analyzed with multivariate logistic regression analysis.
Six hundred ninety-eight patients were included in the study. LTF was 27.8% (194/698). There was a significant difference in LTF between White and non-White (21.5% vs 31.8%, = .003) patients. LTF patients had higher mean SDI scores by ZIP code (59.8 vs 45.7, < .0001). When comparing the most deprived with the least deprived quartile, the odds ratio for LTF was 3.34 (95% CI 2.12-5.27). The patients lost to follow up were also younger (mean age of 6.9 years vs 7.8 years; = .0004). After multivariate logistic regression, higher SDI and younger age remained significant.
Higher social deprivation scores and younger age were associated with LTF in surgically treated pediatric SCHF at this institution.
(1)Patients with higher Social Deprivation Index scores by ZIP code and younger age have higher rates of loss to follow up after pin pull for operatively managed supracondylar humerus fractures.(2)No differences in complications were seen in the loss to the follow-up group compared with those in the group that follow up.
III.
本研究旨在分析手术治疗小儿肱骨髁上骨折（SCHF）后拔针时失访（LTF）的相关危险因素。
对2010年至2020年18岁以下接受手术治疗的SCHF患者进行回顾性队列研究。感兴趣的因素包括失访、年龄、种族、语言、距医院距离、Gartland骨折类型以及邮政编码对应的社会剥夺指数（SDI）。对每个自变量进行单因素逻辑回归分析，并对显著变量进行多因素逻辑回归分析。
本研究纳入698例患者。失访率为27.8%（194/698）。白种人与非白种人患者的失访率存在显著差异（21.5%对31.8%，P = 0.003）。按邮政编码计算，失访患者的SDI平均得分更高（59.8对45.7，P < 0.0001）。将最贫困四分位数与最不贫困四分位数进行比较时，失访的比值比为3.34（95%CI 2.12 - 5.27）。失访患者年龄也更小（平均年龄6.9岁对7.8岁；P = 0.0004）。多因素逻辑回归分析后，较高的SDI和较年轻的年龄仍然具有显著性。
在本机构接受手术治疗的小儿SCHF中，较高的社会剥夺得分和较年轻的年龄与失访相关。
（1）按邮政编码计算社会剥夺指数得分较高且年龄较小的患者，手术治疗肱骨髁上骨折拔针后的失访率较高。（2）与随访组相比，失访组并发症无差异。
III级
