Iran Red Crescent Med J. 2017 January; 19(1):e39328. Published online 2016 August 24. doi: 10.5812/ircmj.39328. Research Article The Impact of Post-Discharge Call Interview to Improve the Screening of Post-Intubation Tracheal Stenosis: An Experimental Study Roya Farzanegan, 1 Maryam Alehashem, 1 Behrooz Farzanegan, 1 Sharareh R Niakan Kalhori, 2 Mohammad Gholami Fesharaki, 3 Farshid Rahimi Bashar, 4 Behjat Barari, 5 Mahdi Zangi, 1 and Mohammad Behgam Shadmehr 1,* 1 Tracheal Diseases Research Center (TDRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IR Iran 2 Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, IR Iran 3 Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran 4 Department of Anesthesiology and Critical Care, School of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran 5 Toxicological Research Center, Department of ClinicalToxicology, Shahid Beheshti University of Medical Sciences, Tehran,IR Iran * Corresponding author: Mohammad Behgam Shadmehr, Professor of Surgery, Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, IR Iran. Tel: +98-2126105387, Fax: +98-2126105387, E-mail: mbshadmehr@sbmu.ac.ir, mbshadmehr@yahoo.com Received 2016 May 25; Revised 2016 June 20; Accepted 2016 July 01. Abstract Background: Tracheal stenosis is one of the worst complications of endotracheal intubation, but timely diagnosis can change its natural history. Management of these patients places a great burden on the health care system and the well-being of the patients and their families. Therefore, discharged intensive-care-unit (ICU) patients who underwent more than 24 hours of intubation should be actively followed-up 3 months after extubation and screened for post-intubation tracheal stenosis. The present study was aimed at assessing the impact of post-discharge follow-up call interviews on increasing successful screening for post-intubation tracheal stenosis. Objectives: To determine the effect of post-discharge call interviews on improving screening of post-intubation tracheal stenosis. Methods: This experimental study was conducted in Iran in September 2014. Using the simple randomization method, 140 patients who had undergone than 24 hours of endotracheal intubation and had received oral and written educational materials upon dis- charge from the ICU were equally assigned to an intervention and a control groups (received a call interview before or after the follow-up due date, respectively). The needed sample size was calculated to be 70 participants in each group (considering α = 5%, the statistical power of 90%, and effect size = 0.4). Results: There was a significant difference in follow-up rates at the due date between the intervention group (50.7%, 34of 67 partic- ipants) and the control group (17.5%, 11 of 63 participants) (OR = 4.871, 95% CI = 2.172 to 10.924, P < 0.0001). In the control group, the call interviews significantly increased the follow-up rate from 17.5% to 66.7 % (42 of 63 participants) (P < 0.0001), although follow- up occurred after the due date. The results of the logistic regression model showed that the patients who had attempted suicide completed follow-up more than those who had not (P = 0.017), that interviews with patients and their parents were more effect than interviews with others (P < 0.05), and that phone call interviews after the follow-up due date were more effective than those before the follow-up due date (OR = 2.653, 95%CI = 1.079 to 6.526, P = 0.034). Conclusions: We highly recommend making call interviews, along with distributing the oral and written educational materials, to increase the follow-up rate among discharged ICU patients. Keywords: Patient Education, Interview, Phone, Follow-Up, Intensive Care Units, Tracheal Stenosis 1. Background Endotracheal intubation in intensive care units (ICU) is a procedure frequently performed in cases of a variety of diseases and conditions to secure the airway (1-3). This pro- cedure can cause early and late complications (4, 5). Post- intubation tracheal stenosis (PITS), one of the worst com- plications, is the most common cause of reconstructive air- way surgery after tracheal intubation (6, 7). Due to respira- tory manifestations, most patients improperly treated for asthma for a long time, and unfortunately, some undergo tracheostomy before a correct diagnosis (8, 9), which com- plicates later definitive airway surgery. The wide variation in incidence rates (6% - 22%) (10, 11) could be affected by the many different local risk factors in each country, such as the prevalence of certain etiologies, the expertise of medi- cal staff, the number and equipment of ICUs, and, most im- portantly, the nursing care of intubated patients. In Iran, one of the most common causes of fatal in- Copyright © 2016, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.