An audit of the care of post-gastrectomy patients

The records of 26 patients in one practice who had had a partial gastrectomy were studied to see if a stated policy of follow-up had been successful. The policy aimed to detect by annual blood tests (birthday follow-up) the consequences of malabsorption of iron, folate, vitamin B12, and calcium. Of 198 possible tests (nine for each patient when seen for the first screening), only 87 (44 per cent) were done; 16 (18.2 per cent) were abnormal. At the 39 opportunities for annual follow-up, 71 per cent of the possible tests were done; 11 of the 62 tests (17.5 per cent) were abnormal. The most common abnormality was deficiency of iron (12 tests), followed by folate (four tests), serum B12 (two tests), and serum calcium (two tests). Appropriate action according to the review criteria was taken for 24 out of the 27 abnormalities found. The result of the review was to suggest a modified annual follow-up, with fewer than nine tests per year.