Predictors of Missed Follow-up Visits in the National Traumatic Brain Injury Model Systems Cohort Study

Abstract

Objective To identify key variables that could predict risk of loss to follow-up (LTFU) in a nationally funded longitudinal database of persons with traumatic brain injury. Design Secondary analysis of a prospective longitudinal cohort study. Setting Traumatic Brain Injury Model System (TBIMS) Centers in the US. Participants A total of 17,956 TBIMS participants (N=17,956) with interview status data available were included if eligible for 1-, 2-, 5-, 10-, 15-, or 20-year follow-ups between October 31, 1989, and September 30, 2020. Interventions Not applicable. Main Outcome Measures Follow-up data collection completion status at years 1, 2, 5, 10, 15, and 20. Results Information relevant to participants’ history, injury characteristics, rehabilitation stay, and patterns of follow-up across 20 years were considered using a series of logistic regression models. Overall, LTFU rates were low (consistently <20%). The most robust predictors of LTFU across models were missed earlier follow-ups and demographic factors including Hispanic ethnicity, lower education, and lack of private health insurance. Conclusions Efforts to retain participants in such social disadvantaged or minority groups are encouraged given their disproportionate rate of LTFU. Repeated attempts to reach participants after a previously missed assessment are beneficial because many participants that missed 1 or more follow-ups were later recovered.