Determining the Clinical Value of Routine Post-operative follow-up in Common Paediatric Surgical Conditions: Prospective Observational Study

Abstract

BACKGROUND: The traditional postoperative visit consists of an in-person hospital visit at a predetermined date requiring investment of time and resources. This study aims to determine , clinical value of routine post-operative physical follow-up for common paediatric surgery conditions, identifying factors determining the need and estimating the cost of follow-up. METHODOLOGY: Data of 226 patients admitted for routine paediatric surgical procedures were collected. The postoperative period was documented in detail and interventions done either physically or telephonically at follow-up were used as a proxy measure of clinical value. RESULTS: Out of 226 patients, 64.6% followed up physically and 35.4%, telephonically. Maximum patients with post-operative complications belonged to laparotomy group (22.2%) followed by complicated appendicitis (15.6%). Thirty (13.3%) patients required clinical intervention at follow-up. Patients with requirements of clinical intervention were observed to follow-up earlier than routine follow-up date, either by telemedicine or physical follow-up. CONCLUSION: Patients undergoing simpler procedures have lesser complications translating to fewer clinic visits whereas those undergoing procedures such as appendectomy and laparotomy require a physical follow-up since they are more susceptible to develop complications requiring interventions. By selecting patients for physical visit we can potentially eliminate unnecessary postoperative visits. Type of study: Prospective Observational Study Level of evidence: Level III