Kevin J Tu, Cole Wymore, Nedelina Tchangalova, Brian M Fuller, Nicholas M Mohr
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We aim to describe the telehealth interventions that have been used to facilitate sepsis care, and to summarize the reported effect of telehealth on sepsis outcomes.</p><p><strong>Data sources: </strong>We identified articles reporting telehealth use for sepsis using an English-language search of PubMed, CINAHL Plus (EBSCO), Academic Search Ultimate (EBSCO), APA PsycINFO (EBSCO), Public Health (ProQuest), and Web of Science databases with no restrictions on publication date.</p><p><strong>Study selection: </strong>Included studies described the use of telehealth as an intervention for treating sepsis. Only comparative effectiveness analyses were included.</p><p><strong>Data extraction and synthesis: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines, two investigators independently selected articles for inclusion and abstracted data. 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引用次数: 0
摘要
目的：败血症会导致大量死亡。远程医疗可提高早期脓毒症护理的质量，但脓毒症远程医疗应用的使用和影响仍不明确。我们旨在描述用于促进脓毒症护理的远程医疗干预措施，并总结报告的远程医疗对脓毒症结果的影响：我们通过对 PubMed、CINAHL Plus (EBSCO)、Academic Search Ultimate (EBSCO)、APA PsycINFO (EBSCO)、Public Health (ProQuest) 和 Web of Science 数据库的英文检索，确定了报道脓毒症远程医疗使用情况的文章，对发表日期没有限制：所纳入的研究描述了使用远程医疗作为治疗败血症的干预措施。数据提取与综合：按照《系统综述和荟萃分析首选报告项目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses）扩展范围综述（PRISMA-ScR）指南，由两名研究人员独立选择纳入文章并摘录数据。对接受远程医疗和未接受远程医疗的患者生存率进行了随机效应亚组分析：共纳入 15 项研究，涉及 188418 名败血症患者。其中 13 项研究采用了观察性研究设计，最常见的远程医疗应用是医疗服务提供者之间的远程医疗咨询和重症监护室远程医疗。临床和方法的异质性非常高。远程医疗的使用与较高的存活率有关，尤其是在对照组存活率较低的情况下。远程医疗对其他护理流程和结果的影响差异较大，可能取决于医院层面的因素：结论：远程医疗在脓毒症护理中的应用多种多样，在某些情况下可能会改善患者的预后。更多的干预性试验和基于成本的分析将明确远程医疗在改善败血症预后方面的因果作用。
The impact of telehealth in sepsis care: A systematic review.
Objectives: Sepsis is associated with significant mortality. Telehealth may improve the quality of early sepsis care, but the use and impact of telehealth applications for sepsis remain unclear. We aim to describe the telehealth interventions that have been used to facilitate sepsis care, and to summarize the reported effect of telehealth on sepsis outcomes.
Data sources: We identified articles reporting telehealth use for sepsis using an English-language search of PubMed, CINAHL Plus (EBSCO), Academic Search Ultimate (EBSCO), APA PsycINFO (EBSCO), Public Health (ProQuest), and Web of Science databases with no restrictions on publication date.
Study selection: Included studies described the use of telehealth as an intervention for treating sepsis. Only comparative effectiveness analyses were included.
Data extraction and synthesis: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines, two investigators independently selected articles for inclusion and abstracted data. A random-effects subgroup analysis was conducted on patient survival treated with and without telehealth.
Results: A total of 15 studies were included, involving 188,418 patients with sepsis. Thirteen studies used observational study designs, and the most common telehealth applications were provider-to-provider telehealth consultation and intensive care unit telehealth. Clinical and methodological heterogeneity was significantly high. Telehealth use was associated with higher survival, especially in settings with low control group survival. The effect of telehealth on other care processes and outcomes were more varied and likely dependent on hospital-level factors.
Conclusions: Telehealth has been used in diverse applications for sepsis care, and it may improve patient outcomes in certain contexts. Additional interventional trials and cost-based analyses would clarify the causal role of telehealth in improving sepsis outcomes.
期刊介绍：
Journal of Telemedicine and Telecare provides excellent peer reviewed coverage of developments in telemedicine and e-health and is now widely recognised as the leading journal in its field. Contributions from around the world provide a unique perspective on how different countries and health systems are using new technology in health care. Sections within the journal include technology updates, editorials, original articles, research tutorials, educational material, review articles and reports from various telemedicine organisations. A subscription to this journal will help you to stay up-to-date in this fast moving and growing area of medicine.
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