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What Factors are Associated with Self-Discharge from Postoperative Therapy After Distal Radius Fractures?
Daniel E Pereira, MD1, Rogelio Coronado, Ph.D2, Jamie Bergner, OTD, OTR/L, CHT, COMT2 and Mihir J. Desai, MD3, (1)Washington University Orthopedics, Saint Louis, MO, (2)Vanderbilt Orthopaedic Institute, Nashville, TN, (3)Vanderbilt Orthopaedics, Nashville, TN

Introduction: Postoperative therapy after distal radius fracture is an essential component for recovery. Little is known about the factors associated with patients' not completing an episode of postoperative therapy. The purpose of this study was to examine the association of sociodemographic and clinical factors on patient self-discharge from to postoperative therapy after distal radius fracture.
Materials and Methods: This was a retrospective review of electronic health data at a single academic medical center. Data from 86 patients (mean [SD] age = 54.2 [14.1] years, 63 [73%] females) with isolated distal radius fractures managed operatively and who initiated postoperative therapy were examined. Sociodemographic factors, comorbidities, and discharge therapy notes were extracted. We categorized patients as those who self-discharged or completed therapy. Univariate logistic analysis with odds ratios (OR) were used to assess the relationship between patient characteristics and self-discharge from therapy.
Results: Overall, patients attended a mean (SD) of 13.2 (8.9) therapy sessions over a mean (SD) of 66.1 (37.4) days after surgery. 17 (19.7%) patients did not complete therapy and self-discharged. No sociodemographic factors were associated with self-discharge (p > 0.05). In univariate analyses, smoking (OR =4.4, p < 0.05), depression (OR = 6.6, p < 0.05), hyperlipidemia (OR = 0.1, p < 0.05), and anxiety (OR = 4.4, p < 0.05) were associated with self-discharge from therapy.
Conclusions: Smoking, depression and anxiety may be important risk factors of non-adherence to postoperative therapy. These findings may assist surgeons in identifying patients who may require additional clinical support or encouragement to enhance therapy engagement.


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