外科手术后的远程医疗护理。

Telehealth for general surgery postoperative care.

机构信息

Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave, Aurora, CO, USA.

出版信息

Am J Surg. 2024 Mar;229:156-161. doi: 10.1016/j.amjsurg.2023.12.025. Epub 2023 Dec 23.

DOI:10.1016/j.amjsurg.2023.12.025

PMID:38158263

Abstract

BACKGROUND

Telehealth utilization rapidly increased following the pandemic. However, it is not widely used in the Veteran surgical population. We sought to evaluate postoperative telehealth in patients undergoing general surgery.

METHODS

Retrospective review of Veterans undergoing general surgery at a level 1A VA Medical Center from June 2019 to September 2021. Exclusions were concomitant procedure(s), discharge with drains or non-absorbable sutures/staples, complication prior to discharge or pathology positive for malignancy.

RESULTS

1075 patients underwent qualifying procedures, 124 (12 %) were excluded and 162 (17 %) did not have follow-up. 443 (56 %) patients followed-up in-person (56 %) vs 346 (44 %) via telehealth. Telehealth patients had a lower rate of complications, 6 % vs 12 %, p = 0.013. There were no significant differences in ED visits, 30-day readmission, postoperative procedures or missed adverse events.

CONCLUSION

Telehealth follow-up after general surgical procedures is safe and effective. Postoperative telehealth care should be considered after low-risk general surgery procedures.

摘要

背景

大流行后，远程医疗的使用迅速增加。然而，它在退伍军人手术人群中并未广泛使用。我们旨在评估普通外科手术后的远程医疗。

方法

回顾性分析 2019 年 6 月至 2021 年 9 月在 1A 级退伍军人事务部医疗中心接受普通外科手术的退伍军人。排除标准为同时进行的手术、带有引流管或不可吸收缝线/钉的出院、出院前出现并发症或病理学检查恶性肿瘤阳性。

结果

1075 名患者接受了合格的手术，124 名（12%）被排除，162 名（17%）没有随访。443 名（56%）患者亲自随访（56%），346 名（44%）通过远程医疗。远程医疗患者的并发症发生率较低，为 6%，而 12%，p=0.013。急诊就诊、30 天再入院、术后手术或不良事件漏诊率无显著差异。