Telephone Follow-Up for Emergency General Surgery Procedures: Safety and Implication for Health Resource Use
Autor: | Tanner C. Carlock, James R. Barrett, Raminder Nirula, James P. Kalvelage, Alexander L. Colonna, Jason B. Young, Toby M. Enniss, Marta L. McCrum, Jade Nunez |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty Population Aftercare 030230 surgery 03 medical and health sciences Patient safety 0302 clinical medicine medicine Humans Prospective Studies Prospective cohort study education Emergency Treatment education.field_of_study business.industry General surgery Middle Aged medicine.disease Umbilical hernia Telephone Inguinal hernia 030220 oncology & carcinogenesis Surgical Procedures Operative Cohort Health Resources Surgery Observational study Female Patient Safety Complication business Facilities and Services Utilization |
Zdroj: | Journal of the American College of Surgeons. 230(2) |
ISSN: | 1879-1190 |
Popis: | Background It is unknown whether replacing clinic follow-up visits with telephone follow-up for low-risk core emergency general surgery (cEGS) procedures is safe. We measured the efficacy of telephone follow-up to determine if it could safely reduce the need for routine postoperative clinic visits in this population. Study Design Low-risk nonelective laparoscopic appendectomy, laparoscopic cholecystectomy, umbilical hernia, and inguinal hernia repair patients received telephone follow-up for symptoms concerning for surgical complication within 10 days of discharge. Clinic appointments were made if critical thresholds were reached. Outcomes of interest included rates of completed telephone screens, clinic visits avoided, and missed complications at 30 days postoperatively. Results Of 402 patients screened, 62 (15.4%) were scheduled for a clinic visit due to threshold responses and 27 (6.7%) were scheduled per patient request, while 275 (68.4%) patients screened negative and did not attend a clinic visit. One hundred sixty-three (59.3%) of the negative screen cohort were contacted after 30 days. Nine (5.5%) patients in this cohort were diagnosed with low-grade complications; no high-grade (Clavien-Dindo ≥ 3) complications were missed by telephone screening. Twenty surgery-related complications were identified in the full patient population; early telephone screening successfully identified the single high-grade complication. Conclusions Post-discharge telephone follow-up in cEGS patients reduced the need for clinic follow-up visits by 68%. Missed complications were infrequent and low grade; telephone screening identified the single high-grade complication. Telephone follow-up for low-risk EGS patients is safe and increases efficiency of postoperative resource use. |
Databáze: | OpenAIRE |
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