A Retrospective Cohort Study on the Effects of Postoperative Phone Calls after Benign Gynecologic Surgery

Abstract

Study Objective To assess whether a postoperative phone call (PPC) from the surgical team reduces patient-initiated contacts, emergency room (ER) visits and readmissions up to 30 days after hysterectomy or myomectomy for benign indications. Design This is a retrospective analysis with propensity matched patient groups. Descriptive statistics were analyzed with Wilcoxon rank sum test and Pearson test were applicable for categorical variables. Univariate logistic regression model was used to assess odds ratio of patient outcomes. Setting Tertiary care academic medical center. Patients or Participants Patients aged 18 years and older who underwent hysterectomy and myomectomy for benign indications from January 2013 to December 2019. Interventions Postoperative phone call within a week after surgery. Measurements and Main Results To date, 90 matched patients (PPC=46, No PPC=44) were selected for preliminary analysis. Of these patients, 16 (34.8%) with PPC and 10 (22.7%) without PPC contacted the office after surgery (p=0.141). The most common reason for contact was vaginal bleeding (34.6%). For ER visits, there were 6 (13.0%) from the PPC group and 9 (20.5%) from the no PCC group (p=0.346), and the most common chief complaint was pain (46.7%). Univariate logistic regression did not find PPC as a significant factor for patient-initiated contacts (1.99 OR, CI 0.80-5.16) nor ER visits (0.58 OR, CI 0.18-1.78). Six patientsrequired readmission all were in the no PPC group (p=0.01). Fever was the most common indication (50.0%). Using a conservative prior, PCC was associated with a lower risk of inpatient admission (0.17 OR, CI 0.01-1.08). Conclusion Patient education regarding vaginal bleeding and pain management after major gynecologic surgery may decrease patient-initiated contacts and ER visits, respectively. Implementation of PCC after major gynecologic surgery may decrease inpatient readmission. To assess whether a postoperative phone call (PPC) from the surgical team reduces patient-initiated contacts, emergency room (ER) visits and readmissions up to 30 days after hysterectomy or myomectomy for benign indications. This is a retrospective analysis with propensity matched patient groups. Descriptive statistics were analyzed with Wilcoxon rank sum test and Pearson test were applicable for categorical variables. Univariate logistic regression model was used to assess odds ratio of patient outcomes. Tertiary care academic medical center. Patients aged 18 years and older who underwent hysterectomy and myomectomy for benign indications from January 2013 to December 2019. Postoperative phone call within a week after surgery. To date, 90 matched patients (PPC=46, No PPC=44) were selected for preliminary analysis. Of these patients, 16 (34.8%) with PPC and 10 (22.7%) without PPC contacted the office after surgery (p=0.141). The most common reason for contact was vaginal bleeding (34.6%). For ER visits, there were 6 (13.0%) from the PPC group and 9 (20.5%) from the no PCC group (p=0.346), and the most common chief complaint was pain (46.7%). Univariate logistic regression did not find PPC as a significant factor for patient-initiated contacts (1.99 OR, CI 0.80-5.16) nor ER visits (0.58 OR, CI 0.18-1.78). Six patientsrequired readmission all were in the no PPC group (p=0.01). Fever was the most common indication (50.0%). Using a conservative prior, PCC was associated with a lower risk of inpatient admission (0.17 OR, CI 0.01-1.08). Patient education regarding vaginal bleeding and pain management after major gynecologic surgery may decrease patient-initiated contacts and ER visits, respectively. Implementation of PCC after major gynecologic surgery may decrease inpatient readmission.