Questionnaire versus telephone follow-up to detect postdischarge complications in surgical patients: randomized...

Postdischarge complications in surgical patients are usually recorded only when readmission is required, a method that likely underestimates the overall complication rate. Our aim was to determine which method-telephone interview or questionnaire by mail-collects the most postdischarge complications.

We performed a randomized clinical equivalence trial. From December 2008 until August 2009, all adult surgical patients admitted to a university hospital were randomized to be approached by mail or by phone 30 days after discharge to collect information about postdischarge complications. Primary outcome was the total number of reported complications after discharge. Secondary outcome was the severity of the complications.

In all, 1595 patients were reached: 890 by means of a telephone interview and 705 through a questionnaire. Response rate was higher in the telephone group than in the questionnaire group (63.8 % vs. 51.3 %). The percentage of patients reporting one or more complications did not differ significantly between the groups: 43.3 % in the telephone group versus 39.6 % in the questionnaire group. Length of stay, American Society of Anesthesiologist class, and type of surgery-but not the survey techniques compared here-significantly influenced the number of complications reported. The percentage of patient-reported complications requiring treatment did not differ significantly between the groups.

The two survey methods did not differ in their ability to appreciate postdischarge complications as reported by the patients. The decision to use either method may be determined by the institution, costs involved, and labor requirement.