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Purpose <p>Firearm-related injuries in children and adolescents have increased over the past decade. The standard of care for ballistic fractures in children is complex, resulting in a burden of healthcare follow-up that many families find challenging. Consistent follow-up is crucial, especially in orthopaedic trauma and firearm cases, to prevent complications. This study aims to identify demographic and clinical variables associated with loss to follow-up (LTFU) in paediatric patients with ballistic fractures.</p> Methods <p>This is a retrospective registry study at a Level I trauma centre for patients aged zero to&#xa0;21 who presented with a ballistic-induced fracture. Patients with isolated skull, facial, or rib fractures were excluded. Follow-up was dichotomized at the median number of follow-up days for analysis. Logistic regression analysis was used to identify predictors of LTFU.</p> Results <p>The study included 144 patients with a median age of 18&#xa0;years. The majority were male (89%) and White (72%). Most patients had government insurance (44%) or were uninsured (33%). The mechanism of injury was primarily assault (71%). Operative intervention occurred in 55% of cases. Key factors increasing follow-up adherence included male sex (p = 0.011), higher injury severity scores (p = 0.009), requiring operative intervention (p &lt; 0.001), air transportation (p &lt; 0.001), or injury at a private residence (p = 0.040). Uninsured status (p = 0.007), opioid use (p = 0.047), and greater distance from the hospital (p = 0.002) were associated with low follow-up.</p> Conclusions <p>This study identifies key factors influencing follow-up adherence in pediatric patients with ballistic fractures. Identifying these factors allows for tailoring future interventions to improve follow-up adherence for this vulnerable population.</p>

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Paediatric ballistic fracture patients: who has poor follow-up and why?

  • 期刊论文

  • 发表日期：

    2025年3月28日

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  • Zachary Jodoin,
  • Daanish Sheikh,
  • Cameron Atkinson,
  • Loc Uyen Vo,
  • Alvaro Moreira,
  • Christina Brady,
  • Boris Zelle

摘要

Purpose

Firearm-related injuries in children and adolescents have increased over the past decade. The standard of care for ballistic fractures in children is complex, resulting in a burden of healthcare follow-up that many families find challenging. Consistent follow-up is crucial, especially in orthopaedic trauma and firearm cases, to prevent complications. This study aims to identify demographic and clinical variables associated with loss to follow-up (LTFU) in paediatric patients with ballistic fractures.

Methods

This is a retrospective registry study at a Level I trauma centre for patients aged zero to 21 who presented with a ballistic-induced fracture. Patients with isolated skull, facial, or rib fractures were excluded. Follow-up was dichotomized at the median number of follow-up days for analysis. Logistic regression analysis was used to identify predictors of LTFU.

Results

The study included 144 patients with a median age of 18 years. The majority were male (89%) and White (72%). Most patients had government insurance (44%) or were uninsured (33%). The mechanism of injury was primarily assault (71%). Operative intervention occurred in 55% of cases. Key factors increasing follow-up adherence included male sex (p = 0.011), higher injury severity scores (p = 0.009), requiring operative intervention (p < 0.001), air transportation (p < 0.001), or injury at a private residence (p = 0.040). Uninsured status (p = 0.007), opioid use (p = 0.047), and greater distance from the hospital (p = 0.002) were associated with low follow-up.

Conclusions

This study identifies key factors influencing follow-up adherence in pediatric patients with ballistic fractures. Identifying these factors allows for tailoring future interventions to improve follow-up adherence for this vulnerable population.