自动创建1年随访预约并发送提醒可改善颈动脉血运重建后的长期随访情况。
Automatic 1-year follow-up appointment creation and reminders can improve long-term follow-up after carotid revascularization.
作者信息
Stonko David P, Mohammed Shira, Skojec Diane, Rutkowski Joanna, Call Diana, Verdi Katherine G, Tsai Lillian L, Black James H, Perler Bruce A, Abularrage Christopher J, Lum Ying Wei, Salameh Maya J, Hicks Caitlin W
机构信息
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA; Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA.
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA.
出版信息
Am J Surg. 2024 Jan;227:57-62. doi: 10.1016/j.amjsurg.2023.09.032. Epub 2023 Sep 27.
BACKGROUND
Long-term follow-up (LTFU) following carotid revascularization is important for post-surgical care, stroke risk optimization and post-market surveillance of new technologies.
METHODS
We instituted a quality improvement project to improve LTFU rates for carotid revascularizations (primary outcome) by scheduling perioperative and one-year follow-up appointments at time of surgery discharge. A temporal trends analysis (Q1 2019 through Q1 2022), multivariable regression, and interrupted time series (ITS) were performed to compare pre-post intervention LTFU rates.
RESULTS
269 consecutive patients were included (151 pre-intervention, 118 post-intervention; mean 71 ± 12 years-old, 39% female, 77% White). The overall LTFU rate improved (64.9%-78.8%; P = 0.013) after the intervention. After controlling for patient factors, procedures performed after the intervention were associated with increased odds of being seen for 1-year follow-up (OR: 2.2 95%CI: 1.2-4.0). Quarterly ITS analysis corroborated this relationship (P = 0.01).
CONCLUSIONS
Time-of-surgery appointment creation and automated patient reminders can improve LTFU rates following carotid revascularizations.
背景
颈动脉血运重建术后的长期随访（LTFU）对于术后护理、优化中风风险以及新技术的上市后监测至关重要。
方法
我们开展了一项质量改进项目，通过在手术出院时安排围手术期和一年期随访预约，以提高颈动脉血运重建术的LTFU率（主要结局）。进行了时间趋势分析（2019年第一季度至2022年第一季度）、多变量回归分析和中断时间序列分析（ITS），以比较干预前后的LTFU率。
结果
纳入269例连续患者（干预前151例，干预后118例；平均年龄71 ± 12岁，女性占39%，白人占77%）。干预后总体LTFU率有所提高（从64.9%提高至78.8%；P = 0.013）。在控制患者因素后，干预后进行的手术与1年随访就诊几率增加相关（OR：2.2，95%CI：1.2 - 4.0）。季度ITS分析证实了这种关系（P = 0.01）。
结论
手术时预约安排和自动患者提醒可提高颈动脉血运重建术后的LTFU率。
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