Establishing and maintaining a remote vascular surgery aortic program: A single-center 5-year experience at the Veterans Affairs.
Aged
Aortic Diseases
/ diagnostic imaging
Delivery of Health Care, Integrated
/ organization & administration
Endovascular Procedures
/ adverse effects
Female
Humans
Male
Middle Aged
Outcome and Process Assessment, Health Care
/ organization & administration
Patient Compliance
Patient Readmission
Postoperative Complications
/ etiology
Program Evaluation
Reoperation
Retrospective Studies
Telemedicine
/ organization & administration
Time Factors
Treatment Outcome
United States
United States Department of Veterans Affairs
Vascular Surgical Procedures
/ adverse effects
Videoconferencing
/ organization & administration
Aorta
Aortic surgery
EVAR
Telehealth
Telemedicine
Videoconference
Journal
Journal of vascular surgery
ISSN: 1097-6809
Titre abrégé: J Vasc Surg
Pays: United States
ID NLM: 8407742
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
received:
22
03
2021
accepted:
24
08
2021
pubmed:
26
9
2021
medline:
8
3
2022
entrez:
25
9
2021
Statut:
ppublish
Résumé
We sought to detail the process of establishing a surgical aortic telehealth program and report the outcomes of a 5-year experience. A telehealth program was established between two regional Veterans Affairs hospitals, one of which was without a comprehensive aortic surgical program, until such a program was established at the referring institution. A retrospective review was performed of all patients who underwent aortic surgery from 2014 to 2019. The operative data, demographics, perioperative complications, and follow-up data were reviewed. From 2014 to 2019, 109 patients underwent aortic surgery for occlusive and aneurysmal disease. Preoperative evaluation and postoperative follow-up were done remotely via telehealth. The median age of the patients was 68 years, 107 were men (98.2%), 28 (25.7%) underwent open aortic repair, and 81 (74.3%) underwent endovascular repair. Of the 109 patients, 101 (92.7%) had a median follow-up of 24.3 months, 5 (4.6%) were lost to follow-up or were noncompliant, 2 (1.8%) were noncompliant with their follow-up imaging studies but responded to telephone interviews, and 1 (0.9%) moved to another state. At the 30-day follow-up, eight patients (7.3%) required readmission. Four complications were managed locally, and four patients (3.6%) required transfer back to the operative hospital for additional care. Telehealth is a great tool to provide perioperative care and long-term follow-up for patients with aortic pathologies in remote locations. Most postoperative care and complications can be managed remotely, and patient compliance for long-term follow-up is high.
Identifiants
pubmed: 34562570
pii: S0741-5214(21)02135-2
doi: 10.1016/j.jvs.2021.08.083
pmc: PMC8863634
mid: NIHMS1742939
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1063-1072Subventions
Organisme : NCI NIH HHS
ID : T32 CA211034
Pays : United States
Informations de copyright
Published by Elsevier Inc.
Références
Oncologist. 2020 Jun;25(6):e936-e945
pubmed: 32243668
J Telemed Telecare. 2018 Jan;24(1):4-12
pubmed: 29320966
Am J Surg. 2020 Jul;220(1):48-49
pubmed: 32336519
J Vasc Surg. 2001 Feb;33(2):345-52
pubmed: 11174788
Diabetes Metab Res Rev. 2020 Mar;36(3):e3247
pubmed: 31808288
J Telemed Telecare. 2020 Jun;26(5):309-313
pubmed: 32196391
Int Wound J. 2015 Jun;12(3):317-21
pubmed: 23796163
Best Pract Res Clin Anaesthesiol. 2016 Sep;30(3):381-93
pubmed: 27650347
J Vasc Surg. 2013 Mar;57(3):734-40
pubmed: 23153421
Ann Vasc Surg. 2018 Jan;46:127-133
pubmed: 28739464
Ann Vasc Surg. 2019 May;57:160-169
pubmed: 30500646
Transl Behav Med. 2021 Mar 16;11(2):659-663
pubmed: 33098426
J Vasc Surg. 2015 Jan;61(1):16-22.e1
pubmed: 25441010
Vasc Endovascular Surg. 2018 Jan;52(1):5-10
pubmed: 29121844
Am Surg. 2001 Apr;67(4):334-40; discussion 340-1
pubmed: 11307999
Acta Inform Med. 2018 Oct;26(3):201-206
pubmed: 30515013
J Telemed Telecare. 2010;16(7):374-7
pubmed: 20679407
J Vasc Surg. 2014 May;59(5):1181-93
pubmed: 24440678
Cardiovasc Diagn Ther. 2018 Apr;8(Suppl 1):S131-S137
pubmed: 29850425
Clin Podiatr Med Surg. 2019 Jul;36(3):361-370
pubmed: 31079603
Int Wound J. 2018 Oct;15(5):707-716
pubmed: 29927043
Semin Plast Surg. 2018 Nov;32(4):159-161
pubmed: 30357052
Vascular. 2017 Aug;25(4):339-345
pubmed: 27903931
Ann Surg. 2009 Aug;250(2):187-96
pubmed: 19638912