Risk Factors for Missed Follow-up Appointments among Facial Trauma Patients.

Abstract

A retrospective case-control study was performed to characterize the rate of missed follow-up appointments after facial trauma and identify associated risk factors. Follow-up appointments for facial trauma over a three-month period at a single, safety-net hospital were analyzed. Appointment-specific, sociodemographic, trauma, and management data were compared between cases (missed appointments) and controls (attended appointments). Univariate testing and multivariable logistic regression were employed. A total of 116 cases and 259 controls were identified, yielding a missed appointment rate of 30.9% (116/375). Missed appointments were significantly associated with initial clinic appointments compared to return visits (odds ratio [OR] 2.21 [1.38 - 3.54]), afternoon visits compared to morning (OR 3.14 [1.94 - 5.07]), lack of private health insurance (OR 2.91 [1.68 - 5.18]), and presence of midface fractures (OR 2.04 [1.28 - 3.27]). Missed appointments were negatively associated with mandible fractures (OR 0.56 [0.35 - 0.89]), surgical management (OR 0.48 [0.30 - 0.77]), and the presence of non-removable hardware (OR 0.39 [0.23 - 0.64]). Upon multivariable logistic regression, missed appointments remained independently associated with afternoon visits (adjusted OR [aOR] 1.95 [1.12 - 3.4]), lack of private health insurance (aOR 2.73 [1.55 - 4.8]), and midface fractures (aOR: 2.09 [1.21 - 3.59]). Nearly one-third of facial trauma patients missed follow-up appointments, with the greatest risk among those with afternoon appointments, lacking private health insurance, and with midface fractures.