Debono Bertrand, Bousquet Philippe, Sabatier Pascal, Plas Jean-Yves, Lescure Jean-Paul, Hamel Olivier
Neurosurgery Department, Neurosciences Pole, CAPIO-Clinique des Cèdres, Château D'Alliez, 31700, Cornebarrieu, France.
Eur Spine J. 2016 Nov;25(11):3536-3542. doi: 10.1007/s00586-016-4680-4. Epub 2016 Jun 27.
The rise of eHealth, with the increasing use of a Mobile application provides a new perspective for outpatient spine surgery follow-up.
Assess the feasibility of Mobile app for postoperative monitoring after outpatient lumbar discectomy.
Sixty consecutive patients, who underwent an ambulatory lumbar discectomy, were proposed the use of Mobile app to optimize their home monitoring for 15 days. Contact was maintained with the clinic based on the level of symptom severity: pain, temperature, deficit, bleeding, to provide a suitable solution. Use of Mobile app compared to the standard follow-up procedure was evaluated daily and a satisfaction survey was carried-out 3 months after surgery.
Thirty-six patients (60.0 %) completed the initial checklist within 48 h, with no triggered severity. Five patients (8.3 %) triggered a non-response alarm; no action was required in the follow-up of 41 patients. However, 19 patients (31.7 %) triggered a total of 29 alarms, automatically resulting in a neurosurgeon contact for: postoperative pain management and optimization of analgesics, 21 cases (72.4 %), low-grade fever <38.5°, 4 cases (13.8 %), voiding delay, 2 cases (6.9 %) and a problem related to dressing, 2 cases (6.9 %). The scale ranged from 1 (poor) to 4 (excellent), with a 3.5/4 overall satisfaction mean score for the mobile handheld-device. Most patients (91.6 %) responded that they would agree to repeat the postoperative experience.
Overall patient satisfaction was excellent. Mobile app provides an effective useful tool for outpatient spine surgery monitoring and minimizes the need for in-person visits for postoperative patients.
随着移动应用程序使用的增加，电子健康的兴起为门诊脊柱手术随访提供了新视角。
评估移动应用程序用于门诊腰椎间盘切除术后监测的可行性。
连续60例接受门诊腰椎间盘切除术的患者被建议使用移动应用程序进行15天的家庭监测优化。根据症状严重程度（疼痛、体温、功能缺损、出血）与诊所保持联系，以提供合适的解决方案。每天评估移动应用程序与标准随访程序相比的使用情况，并在术后3个月进行满意度调查。
36例患者（60.0%）在48小时内完成了初始检查表，且无严重症状触发。5例患者（8.3%）触发了无响应警报；41例患者在随访中无需采取行动。然而，19例患者（31.7%）共触发了29次警报，自动导致与神经外科医生联系，原因如下：术后疼痛管理和镇痛药优化，21例（72.4%）；低热<38.5°，4例（13.8%）；排尿延迟，2例（6.9%）；与敷料相关的问题，2例（6.9%）。评分范围为1（差）至4（优），移动手持设备的总体满意度平均评分为3.5/4。大多数患者（91.6%）表示他们会同意重复术后体验。
患者总体满意度极佳。移动应用程序为门诊脊柱手术监测提供了一种有效的有用工具，并最大限度地减少了术后患者亲自就诊的需求。
