• J. Am. Coll. Surg. · Feb 2020

    Observational Study

    Telephone Follow-Up for Emergency General Surgery Procedures: Safety and Implication for Health Resource Use: Telephone Follow-Up after Surgery.

    • Tanner C Carlock, James R Barrett, James P Kalvelage, Jason B Young, Jade M Nunez, Alexander L Colonna, Toby M Enniss, Raminder Nirula, and Marta L McCrum.
    • Division of General Surgery, Department of Surgery, University of Utah, Salt Lake City, UT.
    • J. Am. Coll. Surg. 2020 Feb 1; 230 (2): 228-236.

    BackgroundIt 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 DesignLow-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.ResultsOf 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.ConclusionsPost-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.Copyright © 2019 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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