Factors Influencing Follow-up Attendance and Its Effect on Functional Outcomes in Middle-Aged and Geriatric Hip Fracture Patients.

Abstract

The purpose of this study was to assess the demographic characteristics of hip fracture patients who followed up versus those who did not and secondarily to evaluate if follow-up duration correlated with long-term functional outcomes. This was a retrospective review that queried a trauma database for all patients aged >55 years with hip fractures because of low-energy mechanisms between February 2019 and May 2020. Demographic characteristics, hospital quality measures, clinical outcomes, follow-up attendance, and 1-year functional outcomes were collected from the electronic medical record or through phone. Comparative analyses were conducted between patients who attended >50% of their follow-up appointments and those who attended <50% of their follow-up appointments. Patients were stratified based on the number of follow-up appointments attended and were compared. Multivariable regression analyses were conducted to identify factors influencing follow-up attendance and its association with functional outcomes. Four hundred fifty-two patients were included for analysis. Patients attending follow-up were younger, more likely to be community ambulators, White, and female. Multivariable regression revealed that younger age, White ethnicity, and female sex were independently associated with higher 1-year follow-up attendance. A positive linear relationship was observed between follow-up attendance and improved functional outcomes. Patients attending >50% of their appointments had better outcome scores. Overall, 218 patients were contacted through phone for 1-year follow-up and thus the 1-year follow-up rate increased to 69%. Consistent follow-up is associated with better 1-year outcomes in geriatric hip fracture patients. Recognizing the demographic factors associated with follow-up attendance can assist in patient education and engagement.