Key result
Routine post-operative follow-up resulted in clinical intervention for only 13.3% of pediatric surgical patients, suggesting that physical visits may be safely eliminated for simpler procedures.
Why the study?
Traditional postoperative in-person visits require substantial time and resources, prompting evaluation of the clinical value, necessity, and cost of routine physical follow-up for common paediatric surgical conditions.
Does routine post-operative physical follow-up provide clinical value compared to telephonic follow-up in common paediatric surgical conditions?
Observational (n=226)
No
Does routine post-operative physical follow-up provide clinical value compared to telephonic follow-up in common paediatric surgical conditions?
Routine physical follow-up may be safely replaced by telemedicine for simple pediatric surgeries, while complex procedures like laparotomy and complicated appendicitis still require in-person visits due to higher complication rates.
Cautions against immediate de-implementation of routine visits in pediatric surgery; leaves open the need for prospective validation.
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
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Menon et al. (2022) conducted an observational in Common paediatric surgical conditions (n=226). Routine post-operative physical follow-up vs. Telephonic follow-up was evaluated on Requirement of clinical intervention at follow-up. Routine post-operative follow-up resulted in clinical intervention for only 13.3% of pediatric surgical patients, suggesting that physical visits may be safely eliminated for simpler procedures.
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