Loss to follow-up after surgery in patients with hip fractures

Abstract

Abstract Background: Non-attendance with scheduled postoperative follow-up visits remains a common problem in orthopaedic clinical researches. The goal of this study was to determine the risk factors for loss to follow-up of hip-fracture patients postoperatively. Methods: A 1-year postoperatively retrospective analysis was conducted on patients who underwent surgery for hip-fractures between January 2017 and December 2018. According to whether they finished the appointed follow-up schedule, the patients were divided into two groups: LTFU Group (Follow-up loss group) and FU Group (Follow-up group). Patients’ clinical outcomes were evaluated by Functional Recovery Score (FRS) questionnaires. Telephone interviews were attempted on those lost to follow-up to determine the reasons. The baseline characteristics between the two groups were compared and the statistical differences were analyzed by logistic regression. Results: 1,041 patients met the inclusion criteria were included in this study, of which 212 (20.37%) patients were lost to follow-up at 1 year postoperatively. The mean age in LTFU Group was 76.70±12.78 and 71.31±13.87 in FU Group (P<0.001). The FRS in LTFU Group were higher than that of FU group (84.0 vs. 82.0, P=0.083), with no significant difference. The logistic regression analysis showed that old age at surgery, fracture type, distance to hospital, Hemiarthroplasty surgery and patients’ transport to hospital by urban-rural public traffic or bus were found to be risk factors for noncompliance with the follow-up visit. Conclusions: Loss to follow-up was common in patients with hip-fracture postoperatively. Our study suggested advanced age, difficult transport, long distance, fracture type and surgical procedures were risk factors for noncompliance. Key Words Hip Fracture, Orthopaedic surgery, Replacement, Internal fixation, Loss, Follow-up