Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Higgs Boson Health, Durham, NC, USA.
J Invasive Cardiol. 2023 Sep;35(9). doi: 10.25270/jic/23.00105.
ManageMySurgery (MMS) is a digital health application (app) for patients undergoing surgery, including Transcatheter Aortic Valve Replacement (TAVR). Patients using MMS review procedure-specific education, view FAQs, and report patient-reported outcomes. This study assessed the impact of app use on postoperative outcomes.
Patients who underwent TAVR and invited to use MMS between March 2019 and November 2021 were identified. Patients received standard perioperative care and were defined as App users if they signed into the app at least once and engaged with at least one task or FAQ. Demographics and postoperative outcomes were collected via medical record review. Multivariable logistic regression models were used to determine odds of 90-day readmission, Emergency Room (ER) visits, and complications.
388 patients met inclusion criteria, of which 238 used the app. The average age at surgery was 76.4±7.7 years for users and 78.1±7.6 for non-users. 63.0% of users and 59.3% of non-users were male. App users had significantly lower 90-day readmission rates, (8.8% vs 16.0%, OR=0.51, p=0.0373), ER visit rates (12.6% vs 27.3%, OR=0.36, p=0.0003), and complication rates (Minor: 12.2% vs 20.7%, OR=0.48, P=0.0126; Major: 8.8% vs. 16%, OR=0.47, P=0.0235).
In this non-randomized, retrospective study, we found significant decreases in 90-day readmissions, ER visits, and complications in TAVR patients using an app compared to traditional care. By engaging patients throughout their interventional journey with structured education and tasks, mobile health platforms may mitigate unnecessary use of emergency and inpatient care, thereby improving patient well-being and lowering the burden on healthcare resources.
ManageMySurgery（MMS）是一款用于接受手术的患者的数字健康应用程序（app），包括经导管主动脉瓣置换术（TAVR）。使用 MMS 的患者可查看特定手术的教育内容、查看常见问题解答，并报告患者报告的结果。本研究评估了使用应用程序对术后结果的影响。
确定了 2019 年 3 月至 2021 年 11 月期间接受 TAVR 并受邀使用 MMS 的患者。患者接受了标准围手术期护理，如果他们至少登录过一次应用程序并至少参与了一个任务或常见问题解答，则被定义为应用程序使用者。通过病历回顾收集人口统计学和术后结果。使用多变量逻辑回归模型确定 90 天再入院、急诊就诊和并发症的几率。
388 名患者符合纳入标准，其中 238 名患者使用了该应用程序。使用者的手术时平均年龄为 76.4±7.7 岁，非使用者为 78.1±7.6 岁。63.0%的使用者和 59.3%的非使用者为男性。使用应用程序的患者 90 天再入院率显著降低（8.8%对 16.0%，OR=0.51，p=0.0373），急诊就诊率（12.6%对 27.3%，OR=0.36，p=0.0003）和并发症发生率（轻微：12.2%对 20.7%，OR=0.48，P=0.0126；严重：8.8%对 16%，OR=0.47，P=0.0235）。
在这项非随机、回顾性研究中，与传统护理相比，使用应用程序的 TAVR 患者 90 天再入院、急诊就诊和并发症的发生率显著降低。通过在患者的介入旅程中为他们提供结构化的教育和任务，移动健康平台可以减少不必要的急诊和住院治疗的使用，从而改善患者的健康状况并减轻医疗资源的负担。
