RS04�COMPARISON OF FRACTURE FOLLOW-UP RATES IN ABORIGINALS VERSUS NON-ABORIGINALS IN AN AUSTRALIAN PERIPHERAL HOSPITAL - BROKEN BUT DID WE FIX IT?

Autor:	L. Plaumann, B. J. Piper, P. Turner, D. Ting
Rok vydání:	2009
Předmět:	medicine.medical_specialty education.field_of_study Pediatrics Treated group Geographical isolation business.industry Population Attendance General Medicine medicine.disease Hospital experience Surgery Diabetes mellitus medicine In patient High incidence business education
Zdroj:	ANZ Journal of Surgery. 79:A66-A66
ISSN:	1445-2197 1445-1433
DOI:	10.1111/j.1445-2197.2009.04929_4.x
Popis:	Purpose: To determine the rate of orthopaedic follow-up of Aboriginal patients and the implications of this on fracture management. Aboriginal patients are at a high risk of complications after fracture given the high incidence of fractures, co-morbidities and later presentation. There is no information in the literature on follow-up of Aboriginal patients after fracture. Methodology: Retrospective review of patients presenting to Kalgoorlie Hospital with a fracture over 12 months. Attendance at follow-up, injury type, treatment type (surgical or non-surgical), indigenous status, and distance from hospital were recorded. Results: A total of 267 patients were identified over a 12 month period, 20% were Aboriginal. Aboriginal patients were ten-fold more likely to be lost to follow-up when compared to non-Aboriginal patients (40% and 4% respectively). Follow-up was further reduced in the Aboriginal group treated surgically (45%) and improved in the conservative group (17%). This pattern was reversed for non-Aboriginal patients where the surgically treated group more likely to present for follow-up. Conclusion: The follow-up of Aboriginal patients is very poor. Our study clearly demonstrates that low follow-up rates are not only related to geographical isolation but the hospital experience itself and mode of management. The failure of Aboriginal patients to present for follow-up has major implications for the management of fractures in this high risk population. We discuss the implications of more conservative treatment to increase follow-up and the conflicting evidence to aggressively internally fix fractures in patients with poor compliance and co-morbidities such as diabetes, common in Aboriginal patients.
Databáze:	OpenAIRE
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