Surgeons are overlooking post-discharge complications: a prospective cohort study
A Visser1, D T Ubbink, D J Gouma
1Department of Surgery, Academic Medical Center, University of Amsterdam, H1-213, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands, a.visser@amc.nl.
World Journal of Surgery
|November 28, 2013
Summary
Patients report more surgical complications after discharge than surgeons record, highlighting a gap in quality monitoring. Addressing these patient-reported issues is crucial for comprehensive surgical care.
Area of Science:
- Surgical Quality Improvement
- Patient Safety
- Health Services Research
Background:
- Surgical complication registration is a key hospital quality indicator.
- Surgeons may under-record post-discharge complications.
- The scope and impact of under-recorded complications are not well understood.
Purpose of the Study:
- To determine the frequency, type, and grade of post-discharge complications.
- To compare patient-reported complications with surgeon-reported data.
Main Methods:
- Prospective cohort study in a University Medical Center's Department of Surgery.
- Phone or questionnaire interviews with adult surgical patients 1 month post-discharge.
- Comparison of patient-reported complications with medical records.
Main Results:
- 976 patients included; 659 complications reported by patients vs. 465 by surgeons.
- Psychological disturbances were significantly under-reported by surgeons (4.2% vs. 0%).
- 80% of patient-reported complications required medical consultation, with various levels of healthcare engagement.
Conclusions:
- Surgeons are often unaware of numerous post-discharge complications experienced by patients.
- Post-discharge complications significantly impact patients and require clinical attention.
- Improved awareness and management of these complications are necessary for quality care.
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