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在 COVID-19 大流行背景下,对心脏移植患者进行快速分诊并过渡到远程医疗。

Rapid triage and transition to telehealth for heart transplant patients in the COVID-19 pandemic setting.

机构信息

Heart Transplant Program, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.

School of Medicine, University of Notre Dame, Notre Dame, USA.

出版信息

J Telemed Telecare. 2024 Oct;30(9):1481-1486. doi: 10.1177/1357633X231151714. Epub 2023 Feb 15.

Abstract

BACKGROUND

In the setting of the COVID-19 pandemic, a rapid uptake of telehealth services was instituted with the aim of reducing the spread of disease to vulnerable patient populations including heart transplant recipients.

METHODS

Single-center, cohort study of all heart transplant patients seen by our institution's transplant program during the first 6 weeks of transition from in-person consultation to telehealth (23 March - 5 June 2020).

RESULTS

Face-to-face consultation allocation strongly favored patients in the early post-operative period (34 vs. 242 weeks post-transplant;  < 0.001). Telehealth consultation dramatically reduced patient travel and wait times (80 min per visit saved in telehealth patients). No apparent excess re-hospitalization or mortality was seen in telehealth patients.

CONCLUSIONS

With appropriate triage, telehealth was feasible in heart transplant recipients, with videoconferencing being the preferred modality. Patients seen face-to-face were those triaged to be higher acuity based on time since transplant and overall clinical status. These patients have the expected higher rates of hospital re-admission, and therefore should continue to be seen in person.

摘要

背景

在 COVID-19 大流行期间,迅速采用远程医疗服务,旨在减少疾病向包括心脏移植受者在内的脆弱患者群体传播。

方法

这是一项单中心队列研究,纳入了我们机构移植项目在从面对面咨询向远程医疗过渡的前 6 周内(2020 年 3 月 23 日至 6 月 5 日)所有接受过心脏移植的患者。

结果

面对面咨询的分配强烈倾向于术后早期的患者(34 周与 242 周;<0.001)。远程医疗咨询大大减少了患者的旅行和等待时间(远程医疗患者每次就诊节省 80 分钟)。远程医疗患者未见明显的再住院或死亡率增加。

结论

通过适当的分诊,远程医疗在心脏移植受者中是可行的,视频会议是首选模式。根据移植时间和整体临床状况,面对面就诊的患者被分诊为更严重的患者。这些患者的再入院率更高,因此应继续进行面对面就诊。

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