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

Abstract

Introduction: 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.

Methods: 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.

Results: 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%.

Conclusion: 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.