PATIENTS PRESENTING EMERGENTLY WITH PROLIFERATIVE DIABETIC RETINOPATHY Follow-up and Factors Associated With Compliance
PATIENTS PRESENTING EMERGENTLY WITH PROLIFERATIVE DIABETIC RETINOPATHY Follow-up and Factors Associated With Compliance
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DOI：
10.1097/iae.0000000000002481
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发表时间：
2020-05-01
影响因子：
3.3
通讯作者：
Vanner, Elizabeth A.
中科院分区：
文献类型：
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作者：
Hinkle, John W.;Flynn, Harry W.;Vanner, Elizabeth A.
目的：确定增生性糖尿病视网膜病变紧急情况后的随访率，并确定与随访依从性相关的患者或就诊特征。方法：对 2014 年 5 月至 2016 年 12 月期间因活动性增殖性糖尿病视网膜病变到眼科急诊就诊的患者进行回顾性队列研究。每次急诊科就诊时都会收集人口统计数据和遭遇数据。随访依从性定义为紧急情况发生后按计划完成的门诊就诊。结果：总共纳入了 590 起急诊科就诊事件。总体随访率为61.9%。已婚患者和拥有公共健康信托保险的患者的依从几率增加（比值比 [OR]：1.507，P = 0.04；OR：2.749，P < 0.0001）。接受医疗补助的患者的几率降低（OR：0.543，P = 0.004）。急诊科就诊时间较长且随访时间间隔较长的患者的几率较低（OR：0.948，P = 0.001；OR 为 0.941，P < 0.0001）。其他特征与随访依从性没有显着相关。结论：紧急出现活动性增殖性糖尿病视网膜病变的患者随访不依从的风险很高。对随访依从性有显着影响的特征包括特定的保险支付者、婚姻状况、就诊时长和随访间隔。
Purpose: To determine the rate of follow-up after emergent encounters for proliferative diabetic retinopathy and to identify patient or visit characteristics associated with follow-up compliance. Methods: A retrospective cohort study of patients presenting to an ophthalmic emergency department with active proliferative diabetic retinopathy between May 2014 and December 2016 was conducted. Demographic data and encounter data were gathered for each emergency department visit. Compliance with follow-up was defined as a completed clinic visit as scheduled after the emergency encounter. Results: A total of 590 emergency department encounters were included. The overall follow-up rate was 61.9%. Married patients and those with Public Health Trust insurance had increased odds of compliance (odds ratio [OR]: 1.507, P = 0.04; OR: 2.749, P < 0.0001). Patients with Medicaid had reduced odds (OR: 0.543, P = 0.004). Patients with longer emergency department encounters and longer intervals to follow-up had reduced odds (OR: 0.948, P = 0.001; OR of 0.941, P < 0.0001). The other characteristics were not significantly associated with follow-up compliance. Conclusion: Patients who present emergently with active proliferative diabetic retinopathy are at high risk of following up noncompliance. Characteristics with significant effects on the odds of follow-up compliance include specific insurance payer, marriage status, length of visit, and interval to follow-up.