Download PDF
Facial Plast Surg
DOI: 10.1055/a-2325-5425
Original Research

Risk Factors for Missed Follow-up Appointments among Facial Trauma Patients

Aaron L. Zebolsky 
1   Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
,
Nina Gallo
1   Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
,
Travis Clarke
1   Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
,
Jeffery A. May
1   Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
,
Raj D. Dedhia
2   Division of Facial Plastic Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
,
Anas Eid
2   Division of Facial Plastic Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

A retrospective case–control study was performed to characterize the rate of missed follow-up appointments after facial trauma and identify associated risk factors.

Follow-up appointments for facial trauma over a 3-month period at a single, safety net hospital were analyzed. Appointment-specific, sociodemographic, trauma, and management data were compared between cases (missed appointments) and controls (attended appointments). Univariate testing and multivariable logistic regression were employed.

A total of 116 cases and 259 controls were identified, yielding a missed appointment rate of 30.9% (116/375). Missed appointments were significantly associated with initial clinic appointments compared to return visits (odds ratio [OR] 2.21 [1.38–3.54]), afternoon visits compared to morning (OR 3.14 [1.94–5.07]), lack of private health insurance (OR 2.91 [1.68–5.18]), and presence of midface fractures (OR 2.04 [1.28–3.27]). Missed appointments were negatively associated with mandible fractures (OR 0.56 [0.35–0.89]), surgical management (OR 0.48 [0.30–0.77]), and the presence of nonremovable hardware (OR 0.39 [0.23–0.64]). Upon multivariable logistic regression, missed appointments remained independently associated with afternoon visits (adjusted OR [aOR] 1.95 [1.12–3.4]), lack of private health insurance (aOR 2.73 [1.55–4.8]), and midface fractures (aOR 2.09 [1.21–3.59]).

Nearly one-third of facial trauma patients missed follow-up appointments, with the greatest risk among those with afternoon appointments, lacking private health insurance, and with midface fractures.

Keywords

facial trauma - maxillofacial injuries - mandibular injuries - lost to follow-up - patient compliance

Previous Presentation

A preliminary form of this study was presented as an oral presentation at the AAO-HNSF 2023 Annual Meeting and OTO Experience in Nashville, TN, from September 30, to October 4, 2023.


Authors' Contributions

A.L.Z.: Conceptualization, data curation, formal analysis, writing—original draft/review and editing.


N.G.: Data curation, writing—review and editing.


T.C.: Data curation, writing—review and editing.


J.A.M.: Data curation, writing—review and editing.


R.D.D.: Conceptualization, methodology, supervision, writing—review and editing.


A.E.: Conceptualization, methodology, supervision, writing—review and editing.




Publication History

Accepted Manuscript online:
14 May 2024

Article published online:
21 June 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Lalloo R, Lucchesi LR, Bisignano C. et al. Epidemiology of facial fractures: incidence, prevalence and years lived with disability estimates from the Global Burden of Disease 2017 study. Inj Prev 2020; 26 (Suppl. 01) i27-i35 [published correction appears in Inj Prev. 2023 Feb;29(1):e1]
    CrossrefPubMedGoogle Scholar
  • 2 Goedecke M, Thiem DGE, Schneider D, Frerich B, Kämmerer PW. Through the ages-aetiological changes in maxillofacial trauma. Dent Traumatol 2019; 35 (02) 115-120
    CrossrefPubMedGoogle Scholar
  • 3 Roccia F, Iocca O, Sobrero F. et al. World Oral and Maxillofacial Trauma (WORMAT) project: a multicenter prospective analysis of epidemiology and patterns of maxillofacial trauma around the world. J Stomatol Oral Maxillofac Surg 2022; 123 (06) e849-e857
    CrossrefPubMedGoogle Scholar
  • 4 Wilson MH, Robinson JP, Sisson RT, Revington PJ, Thomas SJ. The effect of deprivation on the incidence of mandibular fractures in a British city. Surgeon 2017; 15 (02) 65-68
    CrossrefPubMedGoogle Scholar
  • 5 Goodfellow M, Burns A. Relation between facial fractures and socioeconomic deprivation in the north east of England. Br J Oral Maxillofac Surg 2019; 57 (03) 255-259
    CrossrefPubMedGoogle Scholar
  • 6 Kyrgidis A, Koloutsos G, Kommata A, Lazarides N, Antoniades K. Incidence, aetiology, treatment outcome and complications of maxillofacial fractures. A retrospective study from Northern Greece. J Craniomaxillofac Surg 2013; 41 (07) 637-643
    CrossrefPubMedGoogle Scholar
  • 7 Cabalag MS, Wasiak J, Andrew NE, Tang J, Kirby JC, Morgan DJ. Epidemiology and management of maxillofacial fractures in an Australian trauma centre. J Plast Reconstr Aesthet Surg 2014; 67 (02) 183-189
    CrossrefPubMedGoogle Scholar
  • 8 Kao WK, Ho T. The Management of Posttraumatic Nasal Deformities. Facial Plast Surg 2023; 39 (06) 630-637
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Cohen AD, Kaplan DM, Kraus M, Rubinshtein E, Vardy DA. Nonattendance of adult otolaryngology patients for scheduled appointments. J Laryngol Otol 2007; 121 (03) 258-261
    CrossrefPubMedGoogle Scholar
  • 10 Zirkle MS, McNelles LR. Nonattendance at a hospital-based otolaryngology clinic: a preliminary analysis within a universal healthcare system. Ear Nose Throat J 2011; 90 (08) E32-E34
    CrossrefPubMedGoogle Scholar
  • 11 Hunter BN, Cardon B, Oakley GM, Sharma A, Crosby DL. Factors associated with patient nonattendance in rhinology clinics. Am J Rhinol Allergy 2019; 33 (03) 317-322
    CrossrefPubMedGoogle Scholar
  • 12 Fiorillo CE, Hughes AL, I-Chen C. et al. Factors associated with patient no-show rates in an academic otolaryngology practice. Laryngoscope 2018; 128 (03) 626-631
    CrossrefPubMedGoogle Scholar
  • 13 Comer BT, Harris LE, Fiorillo CE, Gal TJ, Hughes A. No-show rates in employed otolaryngology practice. Ear Nose Throat J 2019; 145561319893157
    PubMedGoogle Scholar
  • 14 Stewart MG, Chen AY. Factors predictive of poor compliance with follow-up care after facial trauma: a prospective study. Otolaryngol Head Neck Surg 1997; 117 (01) 72-75
    PubMedGoogle Scholar
  • 15 Hurrell MJL, David MC, Batstone MD. Patient compliance and mandible fractures: a prospective study. Int J Oral Maxillofac Implants 2019; 48 (06) 759-768
    CrossrefPubMedGoogle Scholar
  • 16 Stone Jr ME, Marsh J, Cucuzzo J, Reddy SH, Teperman S, Kaban JM. Factors associated with trauma clinic follow-up compliance after discharge: experience at an urban Level I trauma center. J Trauma Acute Care Surg 2014; 76 (01) 185-190
    CrossrefPubMedGoogle Scholar
  • 17 Truong EI, DeMario BS, Hendrickson S. et al. Factors influencing nonadherence to recommended postdischarge follow-up after trauma. J Surg Res 2020; 256: 143-148
    CrossrefPubMedGoogle Scholar
  • 18 Hope Wilkinson K, Brandolino A, McCormick A. et al. Lost in follow-up: predictors of patient no-shows to clinic follow-up after abdominal injury. J Surg Res 2022; 275: 10-15
    CrossrefPubMedGoogle Scholar
  • 19 Benitez JA, Creel L, Jennings J. Kentucky's Medicaid expansion showing early promise on coverage and access to care. Health Aff (Millwood) 2016; 35 (03) 528-534
    CrossrefPubMedGoogle Scholar
  • 20 Bush ML, Hardin B, Rayle C, Lester C, Studts CR, Shinn JB. Rural barriers to early diagnosis and treatment of infant hearing loss in Appalachia. Otol Neurotol 2015; 36 (01) 93-98
    CrossrefPubMedGoogle Scholar
  • 21 Daar DA, Kantar RS, Cammarata MJ. et al. Predictors of adverse outcomes in the management of mandibular fractures. J Craniofac Surg 2019; 30 (02) 571-577
    CrossrefPubMedGoogle Scholar
  • 22 Hsieh TY, Funamura JL, Dedhia R, Durbin-Johnson B, Dunbar C, Tollefson TT. Risk factors associated with complications after treatment of mandible fractures. JAMA Facial Plast Surg 2019; 21 (03) 213-220
    CrossrefPubMedGoogle Scholar
  • 23 Ahmed A, Wu E, Sarai R, Williams R, Breeze J. Potentially modifiable patient factors in mandible fracture complications: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2022; 60 (03) 266-270
    CrossrefPubMedGoogle Scholar
  • 24 Chan DM, Demuth RJ, Miller SH, Jastak JT. Management of mandibular fractures in unreliable patient populations. Ann Plast Surg 1984; 13 (04) 298-303
    CrossrefPubMedGoogle Scholar
  • 25 Overton TL, Shafi S, Gandhi RR. Local access to care programs increase trauma patient follow-up compliance. Am J Surg 2014; 208 (03) 476-479
    CrossrefPubMedGoogle Scholar
  • 26 Braschi C, Gutierrez G, Liu JK. et al. Impact of automated reminder calls in a safety-net setting on surgical clinic no-show rates. Am Surg 2023; 89: 4955-4957
    CrossrefPubMedGoogle Scholar
  • 27 Shah SJ, Cronin P, Hong CS. et al. Targeted reminder phone calls to patients at high risk of no-show for primary care appointment: a randomized trial. J Gen Intern Med 2016; 31 (12) 1460-1466
    CrossrefPubMedGoogle Scholar
  • 28 Gurol-Urganci I, de Jongh T, Vodopivec-Jamsek V, Atun R, Car J. Mobile phone messaging reminders for attendance at healthcare appointments. Cochrane Database Syst Rev 2013; 2013 (12) CD007458
    PubMedGoogle Scholar
  • 29 Chaiyachati KH, Hubbard RA, Yeager A. et al. Association of rideshare-based transportation services and missed primary care appointments: a clinical trial. JAMA Intern Med 2018; 178 (03) 383-389
    CrossrefPubMedGoogle Scholar
  • 30 Kheirkhah P, Feng Q, Travis LM, Tavakoli-Tabasi S, Sharafkhaneh A. Prevalence, predictors and economic consequences of no-shows. BMC Health Serv Res 2016; 16: 13
    CrossrefPubMedGoogle Scholar
  • 31 Hasvold PE, Wootton R. Use of telephone and SMS reminders to improve attendance at hospital appointments: a systematic review. J Telemed Telecare 2011; 17 (07) 358-364
    CrossrefPubMedGoogle Scholar