Purpose: Follow-up care for incidental findings (IFs) on trauma CT scans is a component of comprehensive healthcare. Our objective was to assess the effectiveness of our incidental findings pre-discharge disclosure practice guideline and identification of factors contributing to follow-up failure.

Methods: Secondary analysis of a prospective observational database: 615 patients with IF November 2019 to February 2020. Follow-up compliance was determined by EMR review and/or a phone call after a mail-out request for voluntary participation. Volunteers answered a pre-determined questionnaire regarding follow-up.

Results: 115 patients (19%) had CT-based IF recommending additional imaging or other follow-up. 74 (64%) patients were lost to inclusion due to:  death (12.1%), inability to contact (51.3%), or noninterest (5.2%). Of the remaining 36 patients, 19 received follow-up care (52.7%) and 17 did not (47.2%). There were no statistical differences between groups in age, gender, mechanism of injury, GCS, whether informed by physicians or midlevel providers, or type of incidental finding. Non-follow-up patients usually didn’t remember the disclosure or discharge paperwork instructions (88%.) Of 19 compliant patients: 9 had additional imaging only, 5 had biopsies and/or surgical intervention (3 cancer, 2 benign), 3 had primary care advise against additional studies and 2 were referred to specialists. 

Conclusions: Predischarge disclosure of IF can contribute significantly to overall patient health. Nonetheless, about half of patients don’t pursue follow-up, most often citing failure to recall verbal/written instructions. More effective communication with attention to health literacy, follow-up phone calls, and appointments are potential catalysts to patient compliance with follow-up recommendations.