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Cosmetic Surgery

Trauma Management

OMS and Other Dental Specialists

Residents

Session: Trauma and Cosmetic Track: Hot-off-the-Press and Abstract Session

GP3b - Structural Barriers to Postoperative Care After Facial Trauma: Predicting Loss to Follow-Up

Friday, October 2, 2026
10:45 AM - 10:55 AM PDT

    Oral Abstract Presenter(s)

  • MR

    Matthew Ryan, DDS

    Resident
    Department of Oral and Maxillofacial Surgery, University of Maryland Medical Center
    Baltimore, Maryland

    • Co-Author(s)

  • SA

    Syed Abdul-Wasay, DDS

    Resident
    Department of Oral and Maxillofacial Surgery, University of Maryland Medical Center
    Baltimore, Maryland

  • NW

    Nicholas Wilken, DDS, MD

    Assistant Professor of Oral and Maxillofacial Surgery
    University of Maryland Medical Center
    Baltimore, Maryland

  • DW

    Darien Weatherspoon, DDS, MPH

    Assistant Professor
    Department of Dental Public Health, University of Maryland School of Dentistry
    Baltimore, Maryland

  • Gary Warburton, DDS, MD

    Professor of Oral and Maxillofacial Surgery
    University of Maryland Medical Center
    Baltimore, Maryland

  • John F. Caccamese, Jr., DMD, MD (he/him/his)

    Professor
    Department of Oral and Maxillofacial Surgery, University of Maryland School of Dentistry
    Baltimore, Maryland

  • Cameron C. Lee, DMD, MD

    Assistant Professor, Oral and Maxillofacial Surgery
    University of Maryland
    Baltimore, Maryland

Abstract: Background: Postoperative loss to follow-up in facial trauma patients is a persistent challenge potentially linked to adverse outcomes. However, predictors of loss to follow-up in this demographic remain poorly characterized.

Purpose: The purpose of this study was to evaluate the association between socioeconomic deprivation, as measured by the Area Deprivation Index (ADI), and postoperative follow-up within 90 days of discharge after operative management of facial trauma.

Study design, setting sample: This was a retrospective cohort study of all adults undergoing operative treatment for facial injuries at the University of Maryland Shock Trauma Center from 2021 to 2024. Patients who died within 90 days of discharge were excluded.

Predictor variable: The predictor was neighborhood socioeconomic deprivation measured using ADI national percentile rankings, categorized into quartiles.

Main outcome variable: The primary outcome was loss to follow-up, defined as failure to attend any postoperative clinic visit within 90 days of discharge.

Covariates: Covariates included demographic (age, race, distance to hospital), social (marital status, employment), and clinical characteristics (etiology, concomitant injuries).

Analyses: Descriptive and bivariate analyses evaluated associations between ADI and loss to follow-up. Multiple logistic regression assessed independent predictors of loss to follow-up.

Results: A total of 881 subjects were included, of which 663 (75.3%) attended follow-up and 218 (24.7%) did not. The cohort had a mean age of 40.8 ± 17.1 years, was 80% male (n = 704), and 47% White (n = 410). In bivariate analysis, higher ADI was associated with loss to follow-up, with subjects in the third (RR 2.21, 95% CI: 1.31 to 3.50) and fourth quartiles (RR 2.21, 95% CI: 1.31 to 3.73) having greater likelihood of missed follow-up. In adjusted analysis, ADI in the third (OR 2.21, 95% CI: 1.15 to 4.23) or fourth quartiles (OR 2.08, 95% CI: 1.01 to 4.27) remained independently associated with loss to follow-up. Emergency department (ED) utilization occurred in 59 subjects (6.70%); one quarter received all postoperative care in the ED.

Conclusions and Relevance: Neighborhood socioeconomic deprivation is an independent predictor of loss to follow-up after facial trauma surgery. Targeted interventions addressing structural barriers may improve continuity of care and reduce avoidable healthcare utilization in this demographic.


References:

1. Yaemsiri S, Alfier JM, Moy E, Rossen LM, Bastian B, Bolin J, Ferdinand AO, Callaghan T, Heron M: Healthy People 2020: Rural Areas Lag In Achieving Targets For Major Causes Of Death. Health Aff (Millwood) 38:2027, 2019.


2. Allareddy V, Allareddy V, Nalliah RP: Epidemiology of facial fracture injuries. J Oral Maxillofac Surg 69:2613, 2011.