Area deprivation index predicts follow-up in retinopathy of prematurity.

BACKGROUND

The risk of progression or development of retinopathy of prematurity (ROP) persists after hospital discharge, and successful outpatient follow-up requires extensive coordination. This study aimed to evaluate the impact of social drivers of health on attendance at outpatient ROP examinations using an area deprivation index (ADI), a census-based composite score indicating neighborhood affluence and opportunity.

METHODS

The medical records of infants evaluated for ROP between January 1, 2016, and May 1, 2023, at the University of Chicago Medical Center were reviewed. The following demographic data were extracted from the record: birth weight, gestational age, sex, race, ethnicity, and insurance status. ADI was calculated based on available maternal demographic data. Univariate and multivariable logistic regressions were performed to evaluate predictors of missed first outpatient appointment.

RESULTS

A total of 540 infants who were evaluated during the study period required additional ROP examinations after discharge. Of these, 174 patients (32%) missed their first outpatient appointment, and 14 (2.6%) did not complete their ROP evaluations. For each level increase in ADI, adjusted odds of missing initial follow-up increased by 17% (95% CI, 7%-28%; P < 0.001). Although race/ethnicity was associated with missed follow-up on unadjusted analyses, the apparent relationship became nonsignificant after adjusting for ADI (OR = 1.21; 95% CI, 0.51-2.88; P = 0.663).

CONCLUSIONS

In our study cohort, patients with high ADI scores, indicating neighborhood disadvantage, were at higher risk of missed outpatient follow-up during the acute phase of ROP evaluation.