Risk Factors for Loss to Follow Up in Pediatric Supracondylar Humerus Fractures

Abstract

ABSTRACT: Background: This study seeks to analyze risk factors associated with loss to follow up (LTF) after pin pull in pediatric patients with operatively treated supracondylar humerus fractures (SCHF). Methods: A retrospective cohort study of patients under 18 years with operative SCHF from 2010 to 2020 was conducted. Factors of interest included LTF, age, race, language, distance to the hospital, Gartland fracture type, and Social Deprivation Index (SDI) by ZIP code. Univariate logistic regression was performed for each independent variable and significant variables were additionally analyzed with multivariate logistic regression analysis. Results: Six hundred ninety-eight patients were included in the study. LTF was 27.8% (194/698). There was a significant difference in LTF between White and non-White (21.5% vs 31.8%, P = .003) patients. LTF patients had higher mean SDI scores by ZIP code (59.8 vs 45.7, P < .0001). When comparing the most deprived with the least deprived quartile, the odds ratio for LTF was 3.34 (95% CI 2.12-5.27). The patients lost to follow up were also younger (mean age of 6.9 years vs 7.8 years; P = .0004). After multivariate logistic regression, higher SDI and younger age remained significant. Conclusions: Higher social deprivation scores and younger age were associated with LTF in surgically treated pediatric SCHF at this institution. Key Concepts: (1) Patients with higher Social Deprivation Index scores by ZIP code and younger age have higher rates of loss to follow up after pin pull for operatively managed supracondylar humerus fractures. (2) No differences in complications were seen in the loss to the follow-up group compared with those in the group that follow up. Level of Evidence: III

Keywords

• Loss to follow-up
• Social determinants of health
• Social Deprivation Index
• Pediatric Orthopaedics
• Trauma