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Determinants of loss to follow-up after eye-related emergency visits: A race-stratified analysis at a level I trauma center.

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Title: Determinants of loss to follow-up after eye-related emergency visits: A race-stratified analysis at a level I trauma center.
Authors: Ersan S; Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States of America., Zhang C; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States of America.; Department of Ophthalmology, Ross Eye Institute, University at Buffalo, Buffalo, New York, United States of America., Yousef Y; Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States of America., Kemmis N; Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States of America., Perreault B; Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States of America., Vardar IF; Rutgers University New Jersey Medical School, Newark, New York, United States of America., Allison KM; Department of Ophthalmology, University of Rochester, Flaum Eye Institute, Rochester, New York, United States of America., Reynolds AL; Department of Ophthalmology, Ross Eye Institute, University at Buffalo, Buffalo, New York, United States of America., DeAngelis MM; Department of Ophthalmology, Ross Eye Institute, University at Buffalo, Buffalo, New York, United States of America.; Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, The University of Utah, Salt Lake City, Utah, United States of America.; Department of Population Health Sciences, University of Utah School of Medicine, The University of Utah, Salt Lake City, Utah, United States of America.; Veterans Administration Western New York Healthcare System, Buffalo, New York, United States of America.; Department of Biochemistry, Jacobs School of Medicine and Biomedical Sciences, State University of New York, University at Buffalo, Buffalo, New York, United States of America.; Genetics, Genomics and Bioinformatics Graduate Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York, University at Buffalo, Buffalo, New York, United States of America.; Neuroscience Graduate Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York, University at Buffalo, Buffalo, New York, United States of America.
Source: PloS one [PLoS One] 2026 Aug 06; Vol. 21 (8), pp. e0355731. Date of Electronic Publication: 2026 Aug 06 (Print Publication: 2026).
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
Imprint Name(s): Original Publication: San Francisco, CA : Public Library of Science
MeSH Terms: Emergency Room Visits*/statistics & numerical data , Eye Diseases*/ethnology , Eye Diseases*/therapy , Eye Injuries*/ethnology , Eye Injuries*/therapy , Racial Groups*/ethnology , Racial Groups*/statistics & numerical data , Lost to Follow-Up*, Black or African American/statistics & numerical data ; Trauma Centers/statistics & numerical data ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; New York
Abstract: Importance: Strict adherence to follow-up ophthalmic care after emergency department visits is critical not only for monitoring disease progression, assessing therapeutic response, and preventing avoidable complications, but also because ophthalmic examinations may provide one of the few opportunities to identify otherwise unrecognized systemic disease.
Objective: To identify variables associated with loss to follow-up (LTFU) care after emergency department ophthalmology consultations, and to characterize similarities and differences between self-reported race.
Design: Retrospective cohort study examining emergency department ophthalmology consultations between January 1st, 2019, and December 31st, 2021, at a level 1 trauma center serving Western New York, Northern Pennsylvania and Southern Ontario.
Setting: Single center study at Erie County Medical Center in Buffalo, New York, USA.
Participants: A total of 2323 ophthalmology consultations were analyzed.
Main Outcomes and Measures: The primary outcome was the rate of LTFU, defined as failure to attend a scheduled outpatient appointment. Demographic, diagnostic, and socioeconomic variables were analyzed across all patients and stratified by self-reported racial group (White, African American/Black, and Other). Logistic regression analysis was performed.
Results: Of the 1697/2323 (73.1%) patients that required an outpatient follow-up at The Ira G. Ross Eye Institute, 1003 (59.1%) identified as White, 489 (28.8%) identified as African American/Black and 205 (12.1%) identified as Other. The overall rate of LTFU was 41.8%, with no significant difference in follow-up rates by racial group on multivariable analysis. In the overall patient cohort, LTFU was significantly more common among patients residing in ZIP codes with lower rates of high school completion, those with a longer interval between the emergency department visit and the scheduled follow-up appointment, and those who presented with near-normal visual acuity (close to 20/20). Among White patients, glaucomatous and retinal diagnoses were associated with lower rates of LTFU. Older age, corneal diagnoses and orbital diagnoses were associated with lower rates of LTFU among African American/Black patients.
Conclusions and Relevance: This study identified both shared and distinct factors associated with LTFU across racial groups. These findings provide a foundation for future studies investigating the mechanisms underlying follow-up adherence and may help inform efforts to improve outpatient follow-up.
(Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Competing Interests: The authors have declared that no competing interests exist.
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Entry Date(s): Date Created: 20260806 Date Completed: 20260806 Latest Revision: 20260813
Update Code: 20260814
PubMed Central ID: PMC13446684
DOI: 10.1371/journal.pone.0355731
PMID: 42560981
Database: MEDLINE
Description
ISSN:1932-6203
DOI:10.1371/journal.pone.0355731