Department of Surgery, University of Washington, 1959 NE Pacific Street Box 356410, Seattle, WA, 98195, USA.
Department of Surgery, University of New Mexico, Albuquerque, NM, 87106, USA.
Obes Surg. 2023 Aug;33(8):2527-2532. doi: 10.1007/s11695-023-06721-0. Epub 2023 Jul 5.
Healthcare-associated activity accounts for 10% of the United States' carbon dioxide (CO) emissions. Using telemedicine for bariatric surgery evaluations decreases emissions and reduces patient burden during the multiple required interdisciplinary visits. After adopting telemedicine during COVID, our clinic continues to utilize telemedicine for preoperative bariatric evaluations. We evaluated the reduced environmental impact associated with this practice.
A retrospective review of all new evaluations for vertical sleeve gastrectomy (SG) or Roux-en Y gastric bypass (RYGB) from 2019 and 2021 was conducted. The 2019 year represents pre-pandemic, in-person evaluations and 2021 represents telemedicine evaluations during the COVID pandemic. Carbon emissions were calculated using the Environmental Protection Agency's (EPA's) validated formula of 404g CO per car-mile. Preoperative evaluation time was calculated from the initial clinic visit to the operation date.
There were 51 patients in the 2019 cohort and 55 patients in the 2021 cohort. In the 2019 in-person cohort, there was significantly more kg of estimated CO emitted (10,225 vs. 2011.4, p<.001) compared to the 2021 cohort. For time required to complete the preoperative workup, there was no statistically significant difference between the two groups (162 days vs. 193 days, p=.226). The attrition rate was lower in the 2021 cohort (22.22% v. 35.9%, p<.001).
Implementation of telemedicine for bariatric preoperative evaluations reduced patient travel, carbon emissions, and improved attrition rate. We encourage bariatric providers to use telemedicine as we believe this eases patient burdens and, with wider adoption, could significantly reduce our carbon footprint.
医疗保健相关活动占美国二氧化碳 (CO) 排放量的 10%。使用远程医疗进行减肥手术评估可减少排放量，并在多次所需的多学科就诊期间减轻患者负担。在 COVID 期间采用远程医疗后，我们的诊所继续将远程医疗用于减肥手术前的评估。我们评估了这种做法带来的环境影响的降低。
对 2019 年和 2021 年所有进行垂直袖状胃切除术 (SG) 或 Roux-en Y 胃旁路术 (RYGB) 的新评估进行回顾性分析。2019 年代表大流行前的面对面评估，2021 年代表 COVID 大流行期间的远程医疗评估。使用环境保护署 (EPA) 验证的公式，即每车每英里 404 克 CO，计算碳排放量。术前评估时间从首次就诊到手术日期计算。
2019 年队列中有 51 例患者，2021 年队列中有 55 例患者。在 2019 年的面对面队列中，与 2021 年队列相比，估计 CO 排放量明显更多（10,225 与 2011.4，p<.001）。对于完成术前检查所需的时间，两组之间没有统计学上的显著差异（162 天与 193 天，p=.226）。2021 年队列的淘汰率较低（22.22%与 35.9%，p<.001）。
对减肥手术前评估实施远程医疗减少了患者的旅行、碳排放，并提高了淘汰率。我们鼓励减肥提供者使用远程医疗，因为我们相信这可以减轻患者的负担，并且随着更广泛的采用，可能会大大减少我们的碳足迹。
