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远程医疗咨询在 COVID-19 大流行期间在口腔颌面外科中的准确性。

Accuracy of Telemedicine Consultations in Oral and Maxillofacial Surgery During the COVID-19 Pandemic.

机构信息

Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Rochester/EIOH, Rochester, NY.

Resident, Department of Oral and Maxillofacial Surgery, University of Rochester/EIOH, Rochester, NY.

出版信息

J Oral Maxillofac Surg. 2023 Jan;81(1):65-71. doi: 10.1016/j.joms.2022.09.016. Epub 2022 Sep 22.

Abstract

PURPOSE

Telemedicine has been an emerging trend over the past few years and has seen an exponential rise due to the COVID-19 pandemic. The purpose of the present study was to determine the accuracy of planned oral and maxillofacial surgery (OMS) procedures for patients seen initially by telemedicine in the department of OMS during the pandemic.

METHODS

This was a retrospective cohort study. Record review of all patients who received telemedicine consultations during the pandemic time frame of March 1, 2020, to March 1, 2021, was performed. The primary outcome was the accuracy of the planned OMS procedure. Accuracy was defined as the ability to conduct the planned surgery with chosen anesthesia (local anesthesia, diazepam + local anesthesia, intravenous sedation, general anesthesia) at the immediate follow-up appointment without the need for further preoperative testing, evaluation, and consultation. The secondary outcomes were to determine the change in surgical plan, anesthesia plan, and medical plan. Predictor variables included age at the time of telemedicine consultation, gender, race, ethnicity, and the type of consult. Descriptive statistics and logistic regression analysis were executed.

RESULTS

The study sample comprised 286 (64.56%) females and 157 (35.44%) males. The age range of the study population was 9 to 92 years, with a mean age of 33.88 years (standard deviation = 16.29 years). In the cohort of 443 patients who obtained telemedicine consultations, 98.19% were successfully treated at the following appointment. Four hundred thirty-one (97.3%) out of the 443 telemedicine consults pertained to dentoalveolar concerns. Logistic regression analysis showed that neither age nor gender had significant effects on the change of surgical and anesthesia plans.

CONCLUSIONS

Telemedicine can be effectively utilized in performing consultations for routine OMS procedures, especially dentoalveolar surgeries. Telemedicine consultation can also be used to conduct a preoperative assessment to determine anesthesia and setting of care. However, given the lack of control group and the observational nature of this study, the results must be interpreted with caution.

摘要

目的

远程医疗在过去几年中是一种新兴趋势,由于 COVID-19 大流行,其数量呈指数级增长。本研究的目的是确定在大流行期间口腔颌面外科(OMS)部门通过远程医疗初次就诊的患者计划的口腔颌面外科手术(OMS)程序的准确性。

方法

这是一项回顾性队列研究。对 2020 年 3 月 1 日至 2021 年 3 月 1 日期间接受远程医疗咨询的所有患者的记录进行了回顾。主要结果是计划 OMS 手术的准确性。准确性定义为能够在立即随访预约时使用所选麻醉(局部麻醉、地西泮+局部麻醉、静脉镇静、全身麻醉)进行计划手术,而无需进一步的术前检查、评估和咨询。次要结果是确定手术计划、麻醉计划和医疗计划的变化。预测变量包括远程医疗咨询时的年龄、性别、种族、族裔以及咨询类型。进行了描述性统计和逻辑回归分析。

结果

研究样本包括 286 名(64.56%)女性和 157 名(35.44%)男性。研究人群的年龄范围为 9 至 92 岁,平均年龄为 33.88 岁(标准差=16.29 岁)。在接受远程医疗咨询的 443 名患者队列中,98.19%的患者在下一次预约时得到成功治疗。443 次远程医疗咨询中有 431 次(97.3%)涉及牙牙槽问题。逻辑回归分析表明,年龄和性别均对手术和麻醉计划的变化无显著影响。

结论

远程医疗可有效用于执行常规 OMS 程序的咨询,特别是牙牙槽手术。远程医疗咨询也可用于进行术前评估,以确定麻醉和护理环境。然而,鉴于缺乏对照组和本研究的观察性质,必须谨慎解释结果。

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