Supervised student-led follow-up of newly cardiac-operated patients did not significantly alter the 1-year unplanned readmission rate (32% vs 30%, p=0.71) compared to standard care.
Cohort (n=419)
Open-label
Computer randomization if eligible patients exceeded logistic capacity
No
Does early additional follow-up by supervised medical students reduce unplanned cardiac-related readmissions in patients undergoing open cardiac surgery?
Supervised student-led early follow-up after open cardiac surgery did not reduce 1-year readmission rates but facilitated earlier detection and non-emergent treatment of complications.
Absolute Event Rate: 32% vs 30%
p-value: p=0.71
Objectives. Readmission rates following open cardiac surgery are high, affecting patients and the cost of care. This study aimed to investigate the effect of early additional follow-up after open cardiac surgery when 5th-year medical students conducted follow-ups under the supervision of physicians. The primary endpoint was unplanned cardiac-related readmissions within one year. The secondary outcomes were the detection of impending complications and health-related quality of life (HRQOL). Methods. Patients undergoing open cardiac surgery were prospectively included. For intervention, additional follow-up visits, including point-of-care ultrasound, were conducted by supervised 5th-year medical students on postoperative days 3, 14 and 25. Unplanned cardiac-related readmissions, including emergency department visits, were registered within the first year of surgery. Danish National Health Survey 2010 questionnaire was used for HRQOL. In standard follow-up, all patients were seen 4-6 weeks postoperative. Results. For data analysis, 100 of 124 patients in the intervention group and 319 of 335 patients in the control group were included. The 1-year unplanned readmission rates did not differ; 32% and 30% in the intervention and control groups, respectively (p = 0.71). After discharge, 1% of patients underwent pericardiocentesis. The additional follow-up initiated scheduled drainage, contrary to more unscheduled/acute drainages in the control group. Pleurocentesis was more common in the intervention group (17% (n = 17) vs 8% (n = 25), p = 0.01) and performed earlier. There was no difference between groups on HRQOL. Conclusion. Supervised student-led follow-up of newly cardiac-operated patients did not alter readmission rates or HRQOL but may detect complications earlier and initiate non-emergent treatment of complications.
Ilkjær et al. (Wed,) conducted a cohort in Open cardiac surgery (n=419). Additional early follow-up by supervised medical students vs. Standard follow-up (4-6 weeks postoperative) was evaluated on Unplanned cardiac-related readmissions within one year (p=0.71). Supervised student-led follow-up of newly cardiac-operated patients did not significantly alter the 1-year unplanned readmission rate (32% vs 30%, p=0.71) compared to standard care.
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