Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation
Objectives To examine the long-term adherence to serial imaging of patients with sporadic vestibular schwannoma and analyze factors associated with being lost to follow-up. Study Design Retrospective chart review with telephone interview. Setting Single tertiary care center. Methods Patients with a...
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Format: | Article |
Language: | English |
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Wiley
2021-08-01
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Series: | OTO Open |
Online Access: | https://doi.org/10.1177/2473974X211036653 |
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author | Mallory Raymond MD Arian Ghanouni Kaitlyn Brooks MD Sarah M. Clark Douglas E. Mattox MD |
author_facet | Mallory Raymond MD Arian Ghanouni Kaitlyn Brooks MD Sarah M. Clark Douglas E. Mattox MD |
author_sort | Mallory Raymond MD |
collection | DOAJ |
description | Objectives To examine the long-term adherence to serial imaging of patients with sporadic vestibular schwannoma and analyze factors associated with being lost to follow-up. Study Design Retrospective chart review with telephone interview. Setting Single tertiary care center. Methods Patients with a sporadic vestibular schwannoma and started on observational surveillance management between January 2005 and December 2010 were included. Demographic data, tumor size, hearing and vestibular changes, and follow-up length were recorded. Patient factors were analyzed for association with being lost to follow-up. Results In total, 122 patients were included with a median length of follow-up of 5 months (range, 0-146). After initial surveillance, 22.1% (n = 27) of patients had a change in management to either microsurgery or radiosurgery. Of the remaining 77.9% (n = 95), nearly half (44.2%, n = 42) never returned for a second visit, and all but 3 were eventually lost to follow-up. There was no association between sex, race, age at diagnosis, initial tumor size, insurance status, household income, or driving distance to hospital and being lost to follow-up. Of 26 interviewed patients initially lost to follow-up, 11 (42.3%) sought care at another institution, 5 (19.2%) chose to no longer receive care, 1 (3.8%) had transportation difficulties, and 9 (36.4%) had poor understanding of their diagnosis or instructions. Conclusions The length of follow-up for patients undergoing surveillance of sporadic vestibular schwannoma varies widely, and patients are commonly lost to follow-up. Further efforts should be made to identify at-risk patients and provide adequate education to improve long-term surveillance. |
first_indexed | 2024-03-09T07:49:35Z |
format | Article |
id | doaj.art-44613adc94994655b370758297ab97d7 |
institution | Directory Open Access Journal |
issn | 2473-974X |
language | English |
last_indexed | 2024-03-09T07:49:35Z |
publishDate | 2021-08-01 |
publisher | Wiley |
record_format | Article |
series | OTO Open |
spelling | doaj.art-44613adc94994655b370758297ab97d72023-12-03T02:05:23ZengWileyOTO Open2473-974X2021-08-01510.1177/2473974X211036653Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial ObservationMallory Raymond MD0Arian Ghanouni1Kaitlyn Brooks MD2Sarah M. Clark3Douglas E. Mattox MD4Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USADepartment of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USAObjectives To examine the long-term adherence to serial imaging of patients with sporadic vestibular schwannoma and analyze factors associated with being lost to follow-up. Study Design Retrospective chart review with telephone interview. Setting Single tertiary care center. Methods Patients with a sporadic vestibular schwannoma and started on observational surveillance management between January 2005 and December 2010 were included. Demographic data, tumor size, hearing and vestibular changes, and follow-up length were recorded. Patient factors were analyzed for association with being lost to follow-up. Results In total, 122 patients were included with a median length of follow-up of 5 months (range, 0-146). After initial surveillance, 22.1% (n = 27) of patients had a change in management to either microsurgery or radiosurgery. Of the remaining 77.9% (n = 95), nearly half (44.2%, n = 42) never returned for a second visit, and all but 3 were eventually lost to follow-up. There was no association between sex, race, age at diagnosis, initial tumor size, insurance status, household income, or driving distance to hospital and being lost to follow-up. Of 26 interviewed patients initially lost to follow-up, 11 (42.3%) sought care at another institution, 5 (19.2%) chose to no longer receive care, 1 (3.8%) had transportation difficulties, and 9 (36.4%) had poor understanding of their diagnosis or instructions. Conclusions The length of follow-up for patients undergoing surveillance of sporadic vestibular schwannoma varies widely, and patients are commonly lost to follow-up. Further efforts should be made to identify at-risk patients and provide adequate education to improve long-term surveillance.https://doi.org/10.1177/2473974X211036653 |
spellingShingle | Mallory Raymond MD Arian Ghanouni Kaitlyn Brooks MD Sarah M. Clark Douglas E. Mattox MD Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation OTO Open |
title | Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation |
title_full | Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation |
title_fullStr | Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation |
title_full_unstemmed | Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation |
title_short | Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation |
title_sort | adherence to long term follow up in patients with sporadic vestibular schwannomas managed with serial observation |
url | https://doi.org/10.1177/2473974X211036653 |
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