Maines Massimiliano, Zorzi Alessandro, Benetollo Pier Paolo, Guarrera Giovanni Maria, Moz Monica, Manica Anna, Demattè Cristina, Del Greco Maurizio
Division of Cardiology, Santa Maria del Carmine Hospital, APSS, Rovereto (Tn), Italy.
Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Italy.
Int J Cardiol Heart Vasc. 2020 Oct;30:100625. doi: 10.1016/j.ijcha.2020.100625. Epub 2020 Sep 2.
During the recent COVID-19 outbreak, Italian health authorities mandated to replace in-person outpatient evaluations with remote evaluations.
From March 16th 2020 to April 22th 2020, all outpatients scheduled for in-person cardiac evaluations were instead evaluated by phone. We aimed to report the short-term follow-up of 345 patients evaluated remotely and to compare it with a cohort of patients evaluated in-person during the same period in 2019.
During a mean follow-up of 54 ± 11 days, a significantly higher proportion of patients evaluated in-person in 2019 visited the emergency department or died for any cause (39/391, 10% versus 13/345 3.7%, p = 0.001) and visited the emergency department for cardiovascular causes (19/391, 4.9% versus 7/345, 2.0%, p = 0.04) compared to 2020. No cardiovascular death was recorded in the two periods. To an evaluation with a satisfaction questionnaire 49% of patients would like to continue using remote controls in addition to traditional ones.
These findings may have important implications for the management of patients during the current COVID-19 pandemic because they suggest that remote cardiovascular evaluations may replace in-hospital visits for a limited period.
在近期新冠疫情爆发期间,意大利卫生当局规定用远程评估取代面对面的门诊评估。
从2020年3月16日至2020年4月22日,所有原定进行面对面心脏评估的门诊患者改为通过电话进行评估。我们旨在报告345例接受远程评估患者的短期随访情况,并将其与2019年同期接受面对面评估的一组患者进行比较。
在平均54±11天的随访期间,2019年接受面对面评估的患者中,前往急诊科就诊或因任何原因死亡的比例显著更高(391例中有39例,10% 对比345例中有13例,3.7%,p = 0.001),且因心血管原因前往急诊科就诊的比例也更高(391例中有19例,4.9% 对比345例中有7例,2.0%,p = 0.04)。两个时期均未记录到心血管死亡病例。在一项满意度问卷调查评估中,49%的患者表示除传统方式外还愿意继续使用远程评估。
这些发现可能对当前新冠疫情期间患者的管理具有重要意义,因为它们表明远程心血管评估在有限时期内可能取代住院就诊。