Is no news good news? Organized follow-up, an absolute necessity for the evaluation of myocardial revascularization

OBJECTIVE: The objective of this study is to find out whether follow-up information is registered by a non-organized follow-up representative for mortality and morbidity after myocardial revascularization. METHODS: The follow-up information registered by an organized (OFU) and a non-organized (NOFU) follow-up method is compared. The organized follow-up consists of an annual survey directly to the patient. The non-organized follow-up contains information provided by cardiologists and general practitioners. 1722 patients undergoing a CABG between 1999 and 2002 were included in this study. Completeness of the follow-up was registered as well as mortality and events, defined as return of angina, myocardial infarction, rhythm disturbances, heart failure, stroke and PTCA. RESULTS: The OFU was 98% complete and the NOFU 51.8% (P<0.05). The NOFU registered only 10 deaths; however, in the OFU another 21 patients who died during the first year postoperative were registered (P<0.05). In the OFU, 137 patients were registered with an event and in the NOFU 53 (P<0.05). In NOFU, the mean was 108+/-91 days and median was 78 days. CONCLUSION: OFU improves the completeness of the follow-up, as expected, but informs superior about mortality and events. That in the NOFU, for 50% of the patients, the information is at the most 78 days postoperative old, let us suppose that a lot of early (6 months) postoperative information is even missed by an NOFU. The establishment of an organized follow-up and feedback of mortality and events after myocardial revascularization becomes indispensable.