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远程医疗用于脑肿瘤神经外科随访的安全性。

Safety of the utilization of telemedicine for brain tumor neurosurgery follow-up.

作者信息

Morell Alexis A, Patel Nitesh V, Eatz Tiffany A, Levy Adam S, Eichberg Daniel G, Shah Ashish H, Luther Evan, Lu Victor M, Kader Michael, Higgins Dominique M O, Ivan Michael E, Komotar Ricardo J

机构信息

Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

出版信息

Neurooncol Pract. 2022 Aug 5;10(1):97-103. doi: 10.1093/nop/npac060. eCollection 2023 Feb.

Abstract

BACKGROUND

There is a need to evaluate the outcomes of patients who underwent brain tumor surgery with subsequent telemedicine or in-person follow-up during the COVID-19 pandemic.

METHODS

We retrospectively included all patients who underwent surgery for brain tumor resection by a single neurosurgeon at our Institution from the beginning of the COVID-19 pandemic restrictions (March 2020) to August 2021. Outcomes were assessed by stratifying the patients using their preference for follow-up method (telemedicine or in-person).

RESULTS

Three-hundred and eighteen (318) brain tumor patients who were included. The follow-up method of choice was telemedicine (TM) in 185 patients (58.17%), and in-person (IP) consults in 133 patients. We found that patients followed by TM lived significantly farther, with a median of 36.34 miles, compared to a median of 22.23 miles in the IP cohort ( = .0025). We found no statistical difference between the TM and the IP group, when comparing visits to the emergency department (ED) within 30 days after surgery (7.3% vs 6.01%, = .72). Readmission rates, wound infections, and 30-day mortality were similar in both cohorts. These findings were also consistent after matching cohorts using a propensity score. The percentage of telemedicine follow-up consults was higher in the first semester (73.17%) of the COVID-19 pandemic, compared to the second (46.21%), and third semesters (47.86%).

CONCLUSIONS

Telehealth follow-up alternatives may be safely offered to patients after brain tumor surgery, thereby reducing patient burden in those with longer distances to the hospital or special situations as the COVID-19 pandemic.

摘要

背景

有必要评估在新冠疫情期间接受脑肿瘤手术并随后通过远程医疗或面对面随访的患者的预后情况。

方法

我们回顾性纳入了自新冠疫情限制措施开始(2020年3月)至2021年8月在我们机构由一名神经外科医生进行脑肿瘤切除手术的所有患者。通过根据患者对随访方式的偏好(远程医疗或面对面)对患者进行分层来评估预后。

结果

共纳入318例脑肿瘤患者。选择远程医疗(TM)随访的患者有185例(58.17%),选择面对面(IP)咨询的患者有133例。我们发现,接受TM随访的患者居住距离显著更远,中位数为36.34英里,而IP组的中位数为22.23英里(P = 0.0025)。在比较术后30天内急诊就诊情况时,我们发现TM组和IP组之间无统计学差异(7.3%对6.01%,P = 0.72)。两个队列的再入院率、伤口感染率和30天死亡率相似。在使用倾向评分匹配队列后,这些结果也一致。与第二学期(46.21%)和第三学期(47.86%)相比,新冠疫情第一学期(73.17%)的远程医疗随访咨询百分比更高。

结论

脑肿瘤手术后可安全地为患者提供远程健康随访替代方案,从而减轻距离医院较远或处于如新冠疫情等特殊情况的患者的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb50/9837772/6f81223acfc0/npac060f0001.jpg

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