Long-term follow-up is possible for short-term surgical trips

Abstract

Introduction: Achieving adequate follow-up for surgical patients is challenging in resource-poor environments, especially for short-term surgical missions (STSM). The aim of this study was to evaluate late postoperative complications (POC) and quality of life (QOL) of surgical patients using mobile phones to facilitate patient follow-up. Methods: Since 2008, an organization sponsored by a US academic institution has conducted surgical trips in partnership with a public hospital in Haiti. During the 2016 trip, mobile phones were used to facilitate follow-up for 2014-2015 operative patients. Late POC and QOL were then evaluated among follow-up patients. Results: Follow-up was achieved in 34 (31%) of 110 operative patients with a mean length of follow-up of 17.8 months (range: 3-60). Of 110 patients, 96 (87%) had phone numbers recorded; phone contact was achieved in 25 (23%) of these patients. Out of a total of 34 follow-up patients, twenty (59%) returned to clinic and 14 (41%) were interviewed solely over the phone. Follow-up patients reported a 41% improvement in ability to complete ADLs (p=0.001) and a 71% reduction in pain (p<0.001). One year after surgery, all seven prostatectomy patients who were previously catheter-dependent no longer required indwelling catheters (p=0.001). Conclusions: To our knowledge, this study is one of the first to utilize mobile phones to acquire long-term follow-up for patients following a STSM. Our results demonstrate that it is possible to measure postoperative outcomes not otherwise obtainable in the perioperative period. Such long-term follow-up is useful and essential for determining the effectiveness and safety of STSMs.