SRS311 - Factors influencing attendance at post-operative rehabilitation following hand trauma: a retrospective three-year analysis

Abstract Background Hand rehabilitation is essential for restoring function following hand trauma surgery, however missed appointments compromise patient outcomes and are costly. The aim of our study was to identify factors contributing to non-attendance of appointments postoperatively. Methods A retrospective review of patients undergoing hand trauma surgery at a London hand trauma unit between January 2020 and April 2023 was conducted. Demographic and clinical data was collected from electronic hospital records including: sex, residential status, occupation, first language, smoking status, follow-up type and procedure type. Primary outcome measured was attendance at first and subsequent follow-up appointments. A multivariate regression analysis was performed to identify independent predictors of non-attendance. Results 303 patients were identified, with an overall non-attendance rate of 4% for initial appointments and 30% for subsequent appointments. Younger patients were less likely to attend follow-up, with each decade of increasing age increasing attendance odds by 48% (OR = 1.042, 95% c.i. 1.019–1.065, P = 0.000). Patients in manual or operational occupations (OR = 0.198, 95% c.i. 0.051–0.774, P = 0.02), those economically inactive (OR = 0.322, 95% c.i. 0.110–0.944, P = 0.039) and smokers (OR = 0.413, 95% c.i. 0.232–0.736, P = 0.003) demonstrated lower attendance rates. Dressings-only appointments were six times more likely to be attended than other appointments (OR = 6.054, 95% c.i. 1.092–33.570, P = 0.039). No significant associations were found between attendance and sex, first language or procedure type. Conclusions Non-attendance of follow-up following hand trauma surgery disproportionately affects younger patients, smokers, manual or operational job workers and economically inactive groups. Targeted interventions such as flexible scheduling, patient education and socioeconomic support may improve engagement, reduce health inequalities and improve rehabilitation outcomes in this patient group.