Loss to follow-up or patient attrition is common in longitudinal studies of traumatic brain injury (TBI). Lack of understanding exists between the relation of study design and patient attrition. This review aimed to identify features of study design that are associated with attrition. We extended the analysis of a previous systematic review on missing data in 195 TBI studies using the Glasgow Outcome Scale Extended (GOSE) as an outcome measure. Studies that did not report attrition or had heterogeneous methodology were excluded, leaving 148 studies. Logistic regression found seven of the 14 design features studied to be associated with patient attrition. Four features were associated with an increase in attrition: greater follow-up frequency (odds ratio [OR]: 1.2, 95% confidence interval [CI]: 1.0–1.3), single rather than multi-center design (OR: 1.6, 95% CI: 1.2–2.2), enrollment of exclusively mild TBI patients (OR: 2.8, 95% CI: 1.6–4.9), and collection of the GOS by post or telephone without face-to-face contact (OR: 1.6, 95% CI:1.1–2.4). Conversely, two features were associated with a reduction in attrition: recruitment in an acute care setting defined as the ward or intensive care unit (OR: 0.58, 95% CI: 0.47–0.72) and a greater duration of time between injury and follow-up (OR: 0.93, 95% CI: 0.88–0.99). This review highlights design features that are associated with attrition and could be considered when planning for patient retention. Further work is needed to establish the mechanisms between the observed associations and potential remedies.

中文翻译：

---

创伤性脑损伤研究中与患者磨损相关的研究设计特征：系统评价。

在创伤性脑损伤 (TBI) 的纵向研究中，失访或患者流失很常见。研究设计与患者流失之间的关系缺乏理解。本综述旨在确定与损耗相关的研究设计特征。我们使用 Glasgow Outcome Scale Extended (GOSE) 作为结果测量扩展了之前对 195 项 TBI 研究中缺失数据的系统评价的分析。没有报告损耗或具有异质方法的研究被排除在外，剩下 148 项研究。Logistic 回归发现研究的 14 个设计特征中有 7 个与患者流失有关。四个特征与流失率增加有关：更高的随访频率（优势比 [OR]：1.2，95% 置信区间 [CI]：1.0-1.3）、单一而非多中心设计（OR：1.6, 95% CI: 1.2–2.2), 仅招募轻度 TBI 患者 (OR: 2.8, 95% CI: 1.6–4.9)，通过邮寄或电话收集 GOS，无需面对面接触 (OR: 1.6，95% 置信区间：1.1–2.4）。相反，有两个特征与减员有关：在定义为病房或重症监护病房的急性护理环境中招募（OR：0.58，95% CI：0.47-0.72）和更长的受伤和随访之间的持续时间 -向上（OR：0.93，95% CI：0.88–0.99）。这篇综述强调了与损耗相关的设计特征，在计划患者保留时可以考虑。需要进一步的工作来建立观察到的关联和潜在补救措施之间的机制。通过邮寄或电话收集 GOS，无需面对面接触（OR：1.6，95% CI：1.1-2.4）。相反，有两个特征与减员有关：在定义为病房或重症监护病房的急性护理环境中招募（OR：0.58，95% CI：0.47-0.72）和更长的受伤和随访之间的持续时间 -向上（OR：0.93，95% CI：0.88–0.99）。这篇综述强调了与损耗相关的设计特征，在计划患者保留时可以考虑。需要进一步的工作来建立观察到的关联和潜在补救措施之间的机制。通过邮寄或电话收集 GOS，无需面对面接触（OR：1.6，95% CI：1.1-2.4）。相反，有两个特征与减员有关：在定义为病房或重症监护病房的急性护理环境中招募（OR：0.58，95% CI：0.47-0.72）和更长的受伤和随访之间的持续时间 -向上（OR：0.93，95% CI：0.88–0.99）。这篇综述强调了与损耗相关的设计特征，在计划患者保留时可以考虑。需要进一步的工作来建立观察到的关联和潜在补救措施之间的机制。72) 和更长的受伤和随访时间间隔 (OR: 0.93, 95% CI: 0.88–0.99)。这篇综述强调了与损耗相关的设计特征，在计划患者保留时可以考虑。需要进一步的工作来建立观察到的关联和潜在补救措施之间的机制。72) 和更长的受伤和随访时间间隔 (OR: 0.93, 95% CI: 0.88–0.99)。这篇综述强调了与损耗相关的设计特征，在计划患者保留时可以考虑。需要进一步的工作来建立观察到的关联和潜在补救措施之间的机制。