这项研究的目的是评估出院后不出勤的危险因素,接受剖腹探查术的外伤患者的医院随访预约。
这是一个回顾性的图表回顾,对在城市接受剖腹探查手术的外伤性腹部损伤的患者,中西部,一级创伤中心,出院后安排诊所随访。临床上,相关的人口特征,患者与医院的距离,还有订书钉的存在,缝线,并收集了需要拆除的排水沟。分类变量的描述性统计以总数和百分比计算,并在适当时与卡方检验或Fisher精确进行比较。
样本包括183名患者,这些患者主要是攻击性创伤幸存者(68%)。男性(80%)和黑人(53%),平均年龄为35.4±14.9岁。总的来说,18.5%的人没有出席他们的后续预约。关于诊所未显示的多变量分析;住院时间(比值比=0.92[0.84-0.99],P=0.04)和缝合的需要,订书钉,或去除排水管对就诊有保护作用(比值比=5.59[1.07-7.01],P=0.04)。总的来说,12例患者(6.4%)再次入院。40例患者(18.3%)在急诊科(ED)进行了随访。关于ED就诊危险因素的多元回归,唯一有统计学意义的因素(P<0.05)是未预约就诊(OR=2.81)和自付保险(OR=4.78)。
腹部创伤患者没有出现随访预约的风险很高,没有出现的就诊与ED就诊相关。未来的工作需要评估干预措施,以改善后续行动。
The aim of this study is to evaluate risk factors for non-attendance to post-discharge, hospital follow-up appointments for traumatically injured patients who underwent exploratory laparotomy.
This is a retrospective chart review of patients who underwent exploratory laparotomy for traumatic abdominal injury at an urban, Midwestern, level I trauma center with clinic follow-up scheduled after discharge. Clinically, relevant demographic characteristics, patients\' distance from hospital, and the presence of staples, sutures, and drains requiring removal were collected. Descriptive statistics of categorical variables were calculated as totals and percentages and compared with a chi-squared test or Fisher\'s exact when appropriate.
The sample included 183 patients who were largely assaultive trauma survivors (68%), male (80%), and black (53%) with a mean age of 35.4 ± 14.9 years. Overall, 18.5% no-showed for their follow-up appointment. On multivariate analysis for clinic no-show; length of stay (odds ratio = 0.92 [0.84-0.99], P = 0.04) and the need for suture, staple, or drain removal were protective for clinic attendance (odds ratio = 5.59 [1.07-7.01], P = 0.04). Overall, 12 patients (6.4%) were readmitted. Forty patients (18.3%) had their follow-up in the emergency department (ED). On multivariate regression of risk factors for ED visits, the only statistically significant factors (P < 0.05) were clinic appointment no-show (OR = 2.81) and self-pay insurance (OR = 4.78).
Abdominal trauma patients are at high risk of no-show for follow-up appointments and no-show visits are associated with ED visits. Future work is needed evaluating interventions to improve follow-up.