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Helen Merritt, Judianne Kellaway, Alice Chuang, Lauren Blieden; Trends of Outpatient Follow-up after Traumatic Lid Laceration Repair. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6050.
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Using a retrospective chart review, the purpose of our study was to determine rate of outpatient follow-up after repair over a 3.5-year period and examine patient demographic, injury, and repair characteristics associated with follow-up compliance.
We reviewed cases repaired at Memorial Hermann Hospital from Jan 2011 through Apr 2014. Injury and repair characteristics including age, insurance status, home address, injury mechanism, repair details, and mental status at time of repair were analyzed. Follow-up was reported as frequency (%). Patient, injury and repair characteristics were summarized by mean (± SD) or frequency (%) by follow-up status and compared using the two-sample t-test or Fisher exact test. Stepwise logistic regression analysis was used to identify the association between follow-up status and patient, injury, and repair characteristics.
218 patients were included. Pediatric patients had a higher percentage of follow-up (71%) than older age groups (57%). Patients with health insurance had a 66% follow-up rate compared to 45% for self-pay patients (P=0.0234). Distance of the patient’s home address from the hospital was not significant. (P=0.6309). Highest follow-up rates were found with patients sustaining blunt trauma not related to assault at 79%. The lowest rate was in patients involved in motor vehicle collisions at 46% (P=0.0025). When analyzing by mental status and presence/absence of drug/alcohol influence at time of repair, we found that 65% of alert and oriented patients followed-up compared to 39% of sedated or altered patients (P=0.0125). Patients that were not under the influence of drugs or alcohol had a rate of 68% compared to 36% of patients intoxicated at time of repair (P=0.0002). Higher rates in patients with other ocular injuries were found at 71% compared to patients with isolated lacerations at 43% (P=0.0001). Of patients repaired in the operating room, 76% followed-up compared with 50% repaired at the bedside (P=0.0001). The odds ratios and 95% confidence intervals are shown in the Table 1.
Patients were less likely to follow-up if uninsured, intoxicated, or had altered mental status at the time of repair. They were more likely to follow-up if under the age of 18, had concurrent ocular injuries, or had repair performed in the operating room. Overall poor rates of follow-up lead us to recommend absorbable repair materials that do not require removal.
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