title: Surgeons are overlooking post-discharge complications: a prospective cohort study.
abstract: BACKGROUND
  The registration of surgical complications is an important quality indicator of hospital medical care. Previous research has suggested that surgeons only record certain complications after discharge. The extent and impact of this potential under-recording of post-discharge complications is unknown. Therefore, we aimed to determine the frequency, type, and grade of post-discharge complications as reported by patients and their surgeons.
  
  
  METHODS
  A prospective cohort study was performed in the Department of Surgery of a University Medical Center. From December 2008 until August 2009, all adult surgical patients were interviewed by phone or questionnaire 1 month after their discharge to inquire about any new complications after discharge. These complications were compared with the surgeon-reported post-discharge complications and letters from the outpatient clinic as documented in the patients' medical files.
  
  
  RESULTS
  A total of 976 patients were included. Patients reported more complications (659) than did surgeons (465), especially psychological disturbances (4.2 vs. 0 %). A medical consult was needed in 527 (80 %) of the patient-reported complications. Of all patient-reported complications, 291 (44 %) resulted in a visit to the outpatient clinic, 144 (22 %) in a consultation with a general practitioner, and 92 (14 %) led to referral to a hospital; 743 (76 %) were treated non-operatively.
  
  
  CONCLUSIONS
  Surgeons are unaware of many of the complications their patients experience after discharge. These post-discharge complications are important to patients and are therefore relevant to be aware of and to act upon whenever necessary.
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, H1-213, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands, a.visser@amc.nl.
authors.forename: A
authors.initials: A
authors.lastname: Visser
authors.forename: D T
authors.initials: DT
authors.lastname: Ubbink
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: J C
authors.initials: JC
authors.lastname: Goslings
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010351:Patient Discharge; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D057566:Self Report; D013043:Specialties, Surgical; D011795:Surveys and Questionnaires