Injury Type and Emergency Department Management of Orthopaedic Patients Influences Follow-up Rates

• DOI: 10.2106/jbjs.m.01481
• Publication Date: 2014-10-01T18:40:53Z
• Authors: Michelle M. Coleman; Laura N. Medford-...; Omar H. Atassi; Angela Siler-Fisher; Charles A. Reitman
• Keywords: Univariate analysis

Orthopaedic clinic follow-up is required to ensure optimal management and outcome for many patients who present the emergency department (ED) with an orthopaedic injury. While several studies have shown that demographic variables influence patient after discharge from ED, objective of this study was examine orthopaedic-related other factors associated failure return outpatient management, so-called "no-show," ED visit.A chart review conducted at a large academic public hospital. Four hundred sixty-four consecutive adult received consult in subsequent referral January through June, 2011, were included. With use chi-square Mann-Whitney univariate tests, data regarding injury type analyzed association no-show. Variables p < 0.25 included multivariate stepwise forward logistic regression analysis.The overall no-show rate 26.1%. Logistic modeling revealed significant differences rates based on cause (odds ratio [OR] 7.51; 95% confidence interval [CI], 2.27 25.1), assault victims having highest rate. Anatomic region significantly influenced (OR 6.61; CI, 1.45 30.5), spine or back complaint Follow-up by resident provider consulted 10.8; 4.11 31.1), not related level training (p = 0.25). The bracing applied 2.46; 1.58 3.96), easier it remove brace (splint), worse 0.0001). Several also predictive nonattendance, including morbid obesity 15.0; 4.83 51.6) current tobacco 5.56; 2.19 15.4).This supports previous evidence high scheduled among treated ED. highlight distinct nonattendance. These findings are useful identifying risk appointments may disposition decisions these patients.