Alexis A Morell, Nitesh V Patel, Tiffany A Eatz, Adam S Levy, Daniel G Eichberg, Ashish H Shah, Evan Luther, Victor M Lu, Michael Kader, Dominique M O Higgins, Michael E Ivan, Ricardo J Komotar
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The follow-up method of choice was telemedicine (TM) in 185 patients (58.17%), and in-person (IP) consults in 133 patients. We found that patients followed by TM lived significantly farther, with a median of 36.34 miles, compared to a median of 22.23 miles in the IP cohort (<i>P</i> = .0025). We found no statistical difference between the TM and the IP group, when comparing visits to the emergency department (ED) within 30 days after surgery (7.3% vs 6.01%, <i>P</i> = .72). Readmission rates, wound infections, and 30-day mortality were similar in both cohorts. These findings were also consistent after matching cohorts using a propensity score. 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引用次数: 0
摘要
背景:有必要评估在COVID-19大流行期间接受脑肿瘤手术的患者随后进行远程医疗或现场随访的结果。方法:我们回顾性纳入了从COVID-19大流行限制开始(2020年3月)到2021年8月在我们机构由一名神经外科医生进行脑肿瘤切除术的所有患者。通过患者偏好的随访方法(远程医疗或面对面)对结果进行分层评估。结果:共纳入318例脑肿瘤患者。随访方式选择远程医疗(TM) 185例(58.17%),当面咨询(IP) 133例。我们发现,与IP队列的中位数22.23英里相比,TM患者的中位数寿命明显更长,为36.34英里(P = 0.0025)。在比较手术后30天内急诊科(ED)就诊情况时,我们发现TM组与IP组之间无统计学差异(7.3% vs 6.01%, P = 0.72)。两组患者的再入院率、伤口感染和30天死亡率相似。在使用倾向评分匹配队列后,这些发现也是一致的。新冠肺炎大流行的第一学期(73.17%)远程医疗随访问诊比例高于第二学期(46.21%)和第三学期(47.86%)。结论:脑肿瘤手术后可安全提供远程医疗随访替代方案,从而减轻距离医院较远或COVID-19大流行等特殊情况下患者的负担。
Safety of the utilization of telemedicine for brain tumor neurosurgery follow-up.
Background: There is a need to evaluate the outcomes of patients who underwent brain tumor surgery with subsequent telemedicine or in-person follow-up during the COVID-19 pandemic.
Methods: We retrospectively included all patients who underwent surgery for brain tumor resection by a single neurosurgeon at our Institution from the beginning of the COVID-19 pandemic restrictions (March 2020) to August 2021. Outcomes were assessed by stratifying the patients using their preference for follow-up method (telemedicine or in-person).
Results: Three-hundred and eighteen (318) brain tumor patients who were included. The follow-up method of choice was telemedicine (TM) in 185 patients (58.17%), and in-person (IP) consults in 133 patients. We found that patients followed by TM lived significantly farther, with a median of 36.34 miles, compared to a median of 22.23 miles in the IP cohort (P = .0025). We found no statistical difference between the TM and the IP group, when comparing visits to the emergency department (ED) within 30 days after surgery (7.3% vs 6.01%, P = .72). Readmission rates, wound infections, and 30-day mortality were similar in both cohorts. These findings were also consistent after matching cohorts using a propensity score. The percentage of telemedicine follow-up consults was higher in the first semester (73.17%) of the COVID-19 pandemic, compared to the second (46.21%), and third semesters (47.86%).
Conclusions: Telehealth follow-up alternatives may be safely offered to patients after brain tumor surgery, thereby reducing patient burden in those with longer distances to the hospital or special situations as the COVID-19 pandemic.
期刊介绍:
Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving