ArticleArchives of orthopaedic and trauma surgery2024
Socioeconomic deprivation is predictive of incomplete postoperative follow-up in patients with tibial shaft fractures.
Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- The Impact of Socioeconomic Disadvantage and Insurance on Delays in Fixation of Distal Radius Fractures.Hand (New York, N.Y.) · 2026Article
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6 authors.
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Abstract
introductionPatients who sustain tibial shaft fractures are at risk for delayed recognition of complications with inadequate postoperative follow-up. Area Deprivation Index (ADI) is a surrogate which may be used to analyze the effects of socioeconomic deprivation on postoperative follow-up rates. The purpose of this study was to determine if ADI is associated with incomplete postoperative follow-up after intramedullary (IM) nailing for fractures of the tibial diaphysis. MATERIALS AND
methods263 patients who underwent IM nailing of extra-articular tibia fractures were retrospectively reviewed. Predictors of incomplete follow-up that were assessed included ADI, Charlson Comorbidity Index (CCI), length of stay (LOS), and discharge disposition. Additional potential predictors included age, sex, race, history of substance abuse, insurance coverage and the presence of polytrauma. ADI was categorized into terciles with T1 (ADI: 1-68; n = 88), T2 (ADI: 69-89; n = 87), and T3 (ADI: 90-100; n = 88) representing the least deprived, intermediate, and most deprived terciles, respectively. Incomplete follow-up was defined as no follow-up after discharge from the hospital or partial follow-up without clearance from orthopaedic care.
resultsTerciles did not differ significantly for LOS (p = 0.351), rates of discharge to home (p = 0.728), differences in CCI (p = 0.972) or health insurance coverage (p = 0.369). ADI was the sole significant predictor of incomplete postoperative follow-up (p < 0.001). Compared to T1, there was a significantly higher risk of incomplete follow-up in both T2 (RR = 1.75, 95% CI: 1.20-2.56) and T3 (RR = 1.88, 95% CI: 1.30-2.74). There was only a marginal difference between T2 and T3 for incomplete follow-up risk (RR = 1.08, 95% CI: 0.82-1.42).
conclusionPatients from areas of higher socioeconomic deprivation are more likely to have incomplete postoperative follow-up after IM nailing of tibial shaft fractures. Allocation of resources towards these patients to improve postoperative follow-up may allow earlier detection of newly developing complications, and avoidance of the cost and morbidity associated with late treatment. LEVEL OF EVIDENCE: III.
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