Association between virtual visits and central line–associated complications in adult patients receiving home parenteral nutrition: A retrospective cohort study

Background

In response to coronavirus disease 19, healthcare organizations made dramatic and immediate shifts from in-person office to telehealth visits to provide care to patients while adhering to social distancing restrictions. The objective of this study was to test the efficacy of virtual visits compared with “brick and mortar” (in-person visits) for patients receiving home parenteral nutrition for clinical outcomes of the incidence of catheter complications and 30-day readmissions.

Methods

A retrospective cohort study was conducted between January 2020 and December 2020 on eligible patients managed by the Cleveland Clinic Home Nutrition Support and the Center Gut Rehabilitation and Transplant teams. Those receiving home parenteral nutrition who were seen in a follow-up clinic appointment were included.

Results

Of 189 patients studied, 103 had in-person visits and 86 had virtual visits. A total of 7.9% (n = 15) of patients had catheter complications. Virtual visits demonstrated statistical noninferiority of the incidence of catheter-related complications when compared with in-person visits (90% CI, −0.051 to 0.106; margin <0.1). Readmission incidence for in-person visits was 8.5% (n = 16) and 6.3% (n = 12) for virtual visits. Virtual visits demonstrated statistical noninferiority to in-person visits for incidence of readmissions after the visit (90% CI, −0.094 to 0.106; margin <0.1).

Conclusion

Virtual visits demonstrate noninferiority to in-person visits based on the incidence of catheter complications and readmission rates. New evaluation techniques need to be developed for this high-risk populations in virtual visits to establish effective and safe patient management.