Factors related to dropout in a study of head and neck cancer patients after surgery

The extent and nature of dropout was assessed in a longitudinal study whose objective was to define and quantify the functional effects of oral surgic al resection and reconstruction on speech and swallowing function in patien ts with head and neck cancer. Of 150 patients who were enrolled to be follo wed up with speech and swallow assessments for 1 year after surgery, 113 (7 5%) dropped out and 37 (25%) returned to complete the study at the final 12 -month evaluation point. In general, those completing the study had a small er resection than the patients who dropped out before the 12-month evaluati on. Fifty percent of the dropout was accounted for by medical reasons, 23% by administrative reasons, and 27% by patient-specific reasons (ie, reasons known only to the patient). Analysis of the dropout categories revealed th at higher cancer stage, larger volume of resection, and having a flap surgi cal closure versus a primary closure or skin graft increased a patient's ch ance of dropping out. A larger volume of resection was also related to an i ncreased chance of being a patient-specific drop-out. Patients who reported no or low alcohol usage had a greater chance of completing follow-up than being a patient-specific dropout.