Predictors of Loss to Follow-Up After Operative Facial Trauma

Outpatient follow-up after operative facial trauma is critical; however, non-compliance remains a pervasive issue. This study aims to identify factors associated with missed initial postoperative appointment.

This single-institution retrospective case-control study included patients who underwent operative facial trauma intervention by an otolaryngology provider at tertiary urban hospitals between January 2020 and April 2025. Sociodemographic, clinical, and operative data were collected. Statistical analysis was performed using STATA, with significance set at p < 0.05.

Of 196 patients, 30 (15.3%) missed their initial post-operative appointment. Patients were less likely to attend their appointment if they self-identified as African American (odds ratio [OR]: 0.245 (0.095, 0.64), p = 0.0024), lacked private insurance (OR: 0.20 (0.072, 0.56), p = 0.009), had a higher Area Deprivation Index (national: 80.82 ± 19.10 vs. 65.05 ± 23.79, p = 0.0011; state: 7.89 ± 2.41 vs. 5.99 ± 2.78, p = 0.008), underwent surgery on an inpatient basis (OR: 0.24 (0.11, 0.56), p = 0.0003), presented with isolated midface trauma (OR: 0.30 (0.11, 0.83, p = 0.015), or were discharged to a location other than home (OR: 0.30 (0.11, 0.82), p = 0.0098). Isolated nasal trauma (OR: 3.10 (1.31, 7.37), p = 0.0079) and having a follow-up appointment scheduled at discharge (OR: 3.61 (1.62, 8.06), p = 0.0011) were protective. After multivariate analysis, missed appointments remained independently associated with isolated midface trauma (adjusted odds ratio [aOR]: 0.17 (0.036, 0.80), p = 0.025), race (aOR: 0.24 (0.063, 0.94), p = 0.041), and follow-up scheduled at discharge (aOR: 5.27 (1.65, 18.14), p = 0.005).

Missed follow-up after operative facial trauma is associated with multiple sociodemographic and clinical factors. Scheduling postoperative appointments before discharge may increase the odds of outpatient follow-up.