Patient follow up care after open heart surgery.

Authors: Odhiambo PA.
Abstract
OBJECTIVE:
To determine the patient drop out to postoperative follow up for heart patients at the Kenyatta National Hospital.
DESIGN SETTING AND PARTICIPANTS:
The study analysed the postoperative attendance of heart patients to the surgical outpatient clinic at the KNH. Data on clinic attendance was collected over a one-year period from patient files and from clinic attendance.
RESULTS:
A total of four hundred and seventy-five open heart operations have been performed at the
Kenyatta National Hospital over the last twenty-five years. The patients' mean age is 18.0 years. Clinic follow up rate over this period is 85% at one-year, 62% at five-years, 32% at ten-years and 13% at fifteen-years. A number of patients who had since fallen out to clinic follow up were traced during the study period, when included into the analysis the revised figures are 85%, 70%, 40% and 24% respectively. The difference is statistically significant (p = 0.019). There was no significant statistical difference in the follow up between males and females (p = 0.278), however between patients operated for congenital heart diseases compared to valve patients, the difference was significant (p = 0.007), valve patients having a better follow up. The five-year follow up for isolated mitral, aortic and double valve replacements were 94%, 74% and 78% respectively.
CONCLUSION:
Despite deceptively good follow up figures, our figures are in fact poor when age is considered. Financial combined with logistical problems are the most likely causes of poor follow up.

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