scholarly journals Patient Loss to Follow-up After Upper Extremity Surgery: A Review of 2563 Cases

Hand ◽  
2018 ◽  
Vol 14 (6) ◽  
pp. 836-840
Author(s):  
Joseph A. Rosenbaum ◽  
Yoni M. Blau ◽  
Hannah K. Fox ◽  
X. Shawn Liu ◽  
Alex C. DiBartola ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Postoperative Care ◽  
Private Insurance ◽  
Demographic Variables ◽  
Loss To Follow Up ◽  
Long Term Follow Up ◽  
Lost To Follow Up ◽  
Surgery Center

Background: Postoperative care is essential to optimizing patient outcome. We sought to determine the incidence and associated demographic and surgical factors of postoperative patient loss to follow-up following hand and upper extremity surgery. Methods: In all, 2834 surgical cases (2467 patients) were retrospectively reviewed. All surgical cases from July 2014 to June 2015 at a single practice with five surgeons were assessed. Charts were reviewed for compliance with postoperative follow-up. Variables were described with proportions and compared using logistic regression analysis. Results: In total, 2563 cases (2388 patients) met the inclusion criteria. Overall loss to follow-up rate was 26%. Patients lost to follow-up based on insurance type were 13% for worker’s compensation, 22% for private insurance, 21% for Medicare, 38% for Medicaid, and 44% for self-pay. Patients with expected short-term follow-up were lost at a 23% rate. Expected mid- and long-term follow-up patients were lost at 34% and 20% rates, respectively. Patients below 30 years old were lost to follow-up at a 42% rate compared to patients 30 to 64 years old (26%) and greater than or equal to 65 years (13%). Males had a higher rate of loss to follow-up, 32%, compared with females (22%). Patients living greater than 50 miles from our surgery center were lost to follow-up at a rate of 31%, compared with those who lived less than 50 miles (25%). Conclusions: We have identified demographic variables associated with patients being lost to follow-up after hand and upper extremity surgery. With this knowledge, we hope to develop methods of either improving in-office follow-up rates or discover new avenues to deliver postoperative care.

How to Find Patients Who are 'Lost to Follow-up'

2010 ◽  
Vol 92 (3) ◽  
pp. 98-101 ◽  
Author(s):  
LC Biant ◽  
VK Eswaramoorthy ◽  
RE Field
Keyword(s):  
Surgical Interventions ◽  
Loss To Follow Up ◽  
Medical Interventions ◽  
Follow Up Studies ◽  
Long Term Follow Up ◽  
Lost To Follow Up

Long-term surveillance of patients is necessary to ascertain the outcome of medical interventions. The rate of 'loss to follow-up' is the largest controllable variable in long-term follow-up studies. Such surveillance programmes are of particular importance to surgical interventions as differences between techniques or implants may take years to become apparent.

Barriers to survivorship care in the Consortium for New England Childhood Cancer Survivors (CONNECCS).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10035-10035
Author(s):  
Cindy L. Schwartz ◽  
Priay Hirway ◽  
Jeremy Ader ◽  
Heather Appleton Bradeen ◽  
Satkiran S. Grewal ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Lymphoblastic Leukemia ◽  
Private Insurance ◽  
Healthcare Access ◽  
Socioeconomic Background ◽  
Survivorship Care ◽  
Cns Disease ◽  
Long Term Follow Up

10035 Background: Although long-term adverse consequences of childhood cancer treatment may be mitigated by screening, prevention, and interventions, many survivors do not take advantage of survivorship care. We hypothesized that patients who are at risk for poor compliance with long-term follow-up are identifiable at diagnosis. Methods: To identify factors associated with poor follow-up compliance, 7 CONNECCS institutions evaluated a childhood acute lymphoblastic leukemia (ALL) survivor cohort diagnosed 1996-99. Data collected included: diagnosis year, age, race, ethnicity, gender, insurance, distance from center, CNS disease, and risk classification. Primary endpoints were compliance with 5 and 10-year follow-up. Differences in compliance were tested using chi-squared or t-tests. Logistic regression (including institution as a clustering variable) was used to calculate adjusted odds ratios (OR). Results: At diagnosis, the 358 ALL patients were: female (47%), age= 6.5 + 4.6 years, white/non-Hispanic (84%), black non-Hispanic (7%), high-risk (52%), CNS involvement (10%), privately insured (68%). Private insurance (OR 4.0; 95% CI 2.1-7.8) significantly increased the odds of 5-year compliance. Compliance with 10-year follow-up increased with private insurance (OR 3.3; 95% CI 1.4-8.1) but decreased with CNS disease (OR 0.36; 95% CI 0.31- 0.42) and with years of age (OR 0.93; 95% CI 0.88- 0.96). Conclusions: We evaluated predictors of long-term follow-up based on disease/demographic characteristics at diagnosis to identify cohorts in need of early interventions. In this regional cohort, patients from lower socioeconomic background (without private insurance) at diagnosis were less likely to participate in long-term follow-up care at 5 and 10 years from diagnosis. Older survivors and those with CNS disease were less likely to be in follow-up at 10 years. Future studies should investigate reasons why follow-up compliance is affected by 1) private insurance at diagnosis, 2) older age, and 3) CNS disease. Remediable causes might include: understanding of risk, adolescence/young adult transitions, and healthcare access.

A single-center retrospective study of patients treated with trabectedin (TRB) with long-term follow up.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11061-11061
Author(s):  
Brett A. Schroeder ◽  
Chad He ◽  
Yuzheng Zhang ◽  
Michael Wagner ◽  
Robin Lewis Jones ◽  
...  
Keyword(s):  
Demographic Variables ◽  
Rank Test ◽  
Prior Chemotherapy ◽  
Pairwise Correlation ◽  
Log Rank Test ◽  
Long Term Follow Up ◽  
Line Of Therapy ◽  
Clinical Trial Information

11061 Background: TRB is FDA approved drug for the treatment of liposarcoma (Lipo) and leiomyosarcoma (LMS). The aim of this study was to evaluate potential biomarkers associated with prolonged benefit in patients treated with TRB at our center prior to 2016. Methods: We performed a retrospective search of UW/FHCRC CASIS database to identify patients treated with TRB prior to 2016. Demographic variables and clinical variables (such as histology and treatment) were retrieved. Statistics were performed with R 3.4.1 software. Pairwise Pearson’s correlation was calculated for the # of prior chemotherapy regimens with # of TRB cycles. The Kaplan-Meir method was used to evaluate overall survival (OS). Log-rank test was conducted to compare groups in terms of OS. Results: 145 sarcoma patients treated with TRB were identified with a mean follow up of 5 years (generally on NCT01427582 or NCT01343277). Patients averaged 1.9 prior chemotherapy regimens prior to TRB (range 0-7 regimens) and received an average of 5.6 TRB doses (range 1-25 doses). Subtypes are listed on table. The # of prior regimens was negatively correlated with the # of TRB cycles that patients received (pairwise correlation coefficient = -1.77; p=0.034), suggesting that multiple prior treatment lines either made TRB less tolerable or made sarcoma less sensitive to TRB. The median OS for this heavily treated metastatic population was 0.5 years. However, patients who were able to stay on TRB for more than 5 cycles had a significantly higher OS (p=0.001). While only 23% of patients who received less than 5 cycles of TRB were alive at 5 years (95% CI: 0.15, 0.32), 53% of those who received 5 or more cycles of (95% CI: 0.39, 0.65) were alive at 5 years. Conclusions: TRB may be more effective when administered as an earlier line of therapy. Patients who are able to stay on TRB for a longer duration had a significant improvement in OS. Detailed subset analysis will be presented as will initial findings of our biomarker work. These retrospective data warrant further evaluation. Clinical trial information: NCT01427582 or NCT01343277. [Table: see text]

Hydroxyapatite-Coated Femoral Stem Survivorship at 10 Years

2005 ◽  
Vol 284-286 ◽  
pp. 1069-0 ◽  
Author(s):  
Gregory Y. Lee ◽  
Ajay Srivastava ◽  
Darryl D. D'Lima ◽  
Pam Pulido ◽  
Clifford W. Colwell
Keyword(s):  
Polyethylene Wear ◽  
Femoral Stem ◽  
Senior Author ◽  
Independent Observer ◽  
Long Term Follow Up ◽  
The Mean ◽  
Lost To Follow Up ◽  
Hip Arthroplasties

The Omnifit-HA femoral stem component has shown excellent results in early clinical studies. This is an independent prospective study of the outcome of a ydroxyapatite-coated femoral component implanted by one surgeon with an intermediate-term follow up. The senior author performed 103 consecutive uncemented total hip arthroplasties in 96 patients from July 1991 to December 1996. The components implanted were the Omnifit-HA femoral stem and the Omnifit PSL porous-coated acetabular shell. The mean age at the time of the index procedure was 52 years old (range, 27–78) and male:female ratio was 54:42. Three patients were deceased and four patients were lost to follow-up. The mean follow up was 10.3 years (range, 7.3–12.7 years). Clinical and radiographic evaluations were performed by an independent observer. The average preoperative and postoperative Harris Hip Scores were 55 and 92, respectively. The overall survivorship of the Omnifit-HA stem was 100% with no femoral revisions. The survivorship of the Omnifit PSL cup was 89.7% with 4 acetabular revisions for aseptic loosening and 6 polyethelene liner exchanges for osteolysis or late instability. The mean polyethylene wear rate was 0.24 mm per year. This long-term follow up shows that the use of circumferentially coated hydroxyapatite stems can protect against the migration of wear debris along the femoral stem.

Long-term follow-up of chemotherapy-induced remissions in patients with disseminated nonseminomatous germ cell tumors

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5029-5029
Author(s):  
Y. Ehrlich ◽  
M. J. Brames ◽  
S. D. Beck ◽  
R. S. Foster ◽  
L. H. Einhorn
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Free Survival ◽  
Nonseminomatous Germ Cell Tumor ◽  
Long Term Follow Up ◽  
Prospective Trials ◽  
Lymph Nodes Dissection ◽  
Lost To Follow Up

5029 Background: There is controversy concerning management of patients (pts) with nonseminomatous germ cell tumor (NSGCT) who obtain a chemotherapy-induced complete radiographic (<1cm node diameter) and serologic remission (CR). It has been our policy not to recommend retroperitoneal lymph nodes dissection (RPLND). Proponents of mandatory RPLND cite a 20% to 30% rate of residual microscopic tumor, mostly teratoma, despite achieving CR. Methods: Retrospective analysis of 141 patients with metastatic NSGCT who obtained CR to cisplatin-based first-line chemotherapy. All were observed without RPLND. Included were 78 consecutive pts treated between Jan 1987 and Sept 1994. Additionally included were 63 pts recruited in 4 prospective trials between Oct 1984 and Apr 2005. Seven pts were lost to follow-up (FU) after <2 year. Results: At a median a FU of 15 years (range 3 months to 23.8 years), 12 pts recurred and 4 are dead of disease (DOD). The estimated 15 year recurrence free and disease specific survival was 90% and 97% respectively. The estimated 15 years recurrence free survival for 109 pts with good risk and 32 pts with intermediate or poor risk was 95% and 73% respectively (p = 0.001). Five pts recurred >2 years (range 3–13 years). All 5 are currently disease free. Six pts recurred in the RP and 2 are DOD. Six pts recurred outside the RP. Two of these 6 are DOD. Conclusions: Pts obtaining CR after primary chemotherapy can be safely observed without RPLND. Relapses are rare and potentially curable with further treatment. No significant financial relationships to disclose.

Urgent-SQ Implant: Safety and Efficacy, 18 Years After First Implantation.

2020 ◽  
Author(s):  
Manon te Dorsthorst ◽  
Dick Janssen ◽  
Frank Martens ◽  
Michael van Balken ◽  
John Heesakkers
Keyword(s):  
Tibial Nerve ◽  
Nerve Stimulator ◽  
Safety Issues ◽  
Follow Up Studies ◽  
Long Term Follow Up ◽  
Internal Component ◽  
Lost To Follow Up ◽  
Self Stimulation

Abstract Background: To evaluate the long term follow up in terms of safety and usability of the Urgent-SQ system (implantable tibial nerve stimulator) based on 1 year, 9 year follow up and novel results 18 years after first implantation in 2002.Materials & Methods: Since 2002, eight patients were implanted with the Urgent-SQ system. Seven patients were included in previous follow up studies, 1 patient had loss of efficacy before 1 year of follow up. During this study all patients who were included in the previous follow-up studies (n=7) were contacted to be interviewed regarding efficacy, usability and safety. Results: Five out of seven patients were available for assessment, mean age 72 years ± 8 (range 65-82). Two patients were considered lost to follow up. None of the interviewed patients reported safety issues, new adverse events or discomfort. One of the patients was able to visit the hospital for efficacy. However, treatment could not be performed due to deficiency of the external or internal component. All patients did not perform self-stimulation anymore due to external stimulator deficiency (n=2) or loss of effect (n=3). Conclusion: 18 year follow up of the Urgent-SQ implant demonstrates a high safety profile. However efficacy after 18 years is lacking in 60% whereas in 40% the therapy cannot be applied because the external stimulator is deficient. This most likely depicts the end of the lifecycle of the device.

scholarly journals Area Deprivation Index Score Is Associated With Lower Rates of Long-Term Follow-up After Upper Extremity Vascular Injuries

2018 ◽  
Vol 68 (3) ◽  
pp. e63-e64 ◽  
Author(s):  
Mina L. Boutrous ◽  
Anh L. Ta ◽  
Yuqian Tian ◽  
Carl A. Freeman ◽  
Matthew R. Smeds
Keyword(s):  
Upper Extremity ◽  
Index Score ◽  
Deprivation Index ◽  
Area Deprivation ◽  
Vascular Injuries ◽  
Long Term Follow Up
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