Profile of Patients Lost to Follow-Up in the Burn Injury Rehabilitation Model Systemsʼ Longitudinal Database

Abstract

We sought to identify whether patterns exist in the Burn Injury Rehabilitation Model Systems' database among participants lost to follow-up at 6, 12, or 24 months after injury and to define characteristics that reliably discriminate between persons who are lost to follow-up and those who are not. All participants met the American Burn Association criteria for major burn injury, were 18 years of age or older, received care from one of four burn model systems, and consented to participate in a 2-year prospective data-collection process. Step-wise logistic regression was used to develop three prediction models for the probability of loss to follow-up. The percent of individuals successfully contacted for follow-up were 64% at 6 months, 54% at 12 months, and 42% at 24 months after injury. Individuals who were younger, not employed at time of burn, with less than a high school level education, a history of drug abuse, circumstances of injury involving suspected assault, and having no insurance for care were lost to follow-up. Longer stay in the hospital, on the other hand, increased the likelihood of follow-up. The same risk factors remained significant with or without adjusting for site indicating that these factors are independent and significant in spite of any potential site differences. Successful follow-up at 6- and 12-month intervals increased the likelihood of achieving a follow-up at 24 months after injury. The sociodemographic risk factors for attrition identified in this study represent significant enduring vulnerabilities. The findings necessitate a close examination of several factors and the use of strategies to reduce the risk of attrition.

Psychological Distress After Major Burn Injury

“…First, participant dropout was high, thus lowering confidence in the obtained evidence. The consistently observed high attrition in this population suggests the need to develop novel approaches to retention (40). Second, unmeasured factors such as preburn characteristics (e.g., resilience, personality, coping style, medications and details of acute treatment, formal lifetime and current psychiatric diagnoses and treatments, family psychiatric history) and trauma-related factors (e.g., trauma severity) could affect results.…”

“…The allowable period of time to complete the assessment at a given follow-up was defined as starting 1 month before the actual date, and ending 2 months after the actual date. This redundancy was built into the design to attempt to maximize data collection, because problems in this population have historically resulted in excess attrition (problems include frequent address changes due to home/property destruction, loss of job, opportunity elsewhere, avoidance of reminders of the injury and hospitalization, and fear of collection agency contact) (40). During the index hospitalization, the research assistants assessed symptoms of psychological distress during the week before discharge (i.e., baseline).…”

Interim pressure garment therapy: an investigation into the use of low level pressure therapy for burns donor site support and scar management

“…The rate of dropout in this study corresponds to those of Holavanahalli et al (2006) who described participation rates at 6, 12, and 24 months follow-up time points as reducing over time from 64%, to 54%, and 42% respectively.…”

“…With this in mind, large numbers of participants are required to account for attrition rates (Holavanahalli et al, 2006)such as those found in this study.…”

Body Image Quality of Life Inventory - BIQLI: Adaptação para o português e validação para pacientes brasileiros, vítimas de queimaduras

“…Em nosso estudo, a média de anos de instrução dos participantes foi baixa (Tabela 1). Estudos realizados em outros países como Estados Unidos (FAUERBACH et al, 1999;HOLAVANAHALLI et al, 2006) e Irã (REZAIE et al, 2011) têm mostrado que a queimadura atinge frequentemente populações com baixo nível de instrução.…”