Use of a Bluetooth tablet-based technology to improve outcomes in lung transplantation: A pilot study.

Autor: Schenkel FA; Keck Medical Center, University of Southern California, Los Angeles, California, USA., Barr ML; Division of Cardiothoracic Surgery, Department of Surgery, University of Southern California, Los Angeles, California, USA., McCloskey CC; ActiCare Health, Livermore, California, USA., Possemato T; Keck Medical Center, University of Southern California, Los Angeles, California, USA., O'Conner J; Keck Medical Center, University of Southern California, Los Angeles, California, USA., Sadeghi R; Keck Medical Center, University of Southern California, Los Angeles, California, USA., Bembi M; Keck Medical Center, University of Southern California, Los Angeles, California, USA., Duong M; Keck Medical Center, University of Southern California, Los Angeles, California, USA., Patel J; Keck Medical Center, University of Southern California, Los Angeles, California, USA., Hackmann AE; Division of Cardiothoracic Surgery, Department of Surgery, University of Southern California, Los Angeles, California, USA., Ganesh S; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Southern California, Los Angeles, California, USA.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2020 Dec; Vol. 20 (12), pp. 3649-3657. Date of Electronic Publication: 2020 Jul 13.
DOI: 10.1111/ajt.16154
Abstrakt: The impact of remote patient monitoring platforms to support the postoperative care of solid organ transplant recipients is evolving. In an observational pilot study, 28 lung transplant recipients were enrolled in a novel postdischarge home monitoring program and compared to 28 matched controls during a 2-year period. Primary endpoints included hospital readmissions and total days readmitted. Secondary endpoints were survival and inflation-adjusted hospital readmission charges. In univariate analyses, monitoring was associated with reduced readmissions (incidence rate ratio [IRR]: 0.56; 95% confidence interval [CI]: 0.41-0.76; P < .001), days readmitted (IRR: 0.46; 95% CI: 0.42-0.51; P < .001), and hospital charges (IRR: 0.52; 95% CI: 0.51-0.54; P < .001). Multivariate analyses also showed that remote monitoring was associated with lower incidence of readmission (IRR: 0.38; 95% CI: 0.23-0.63; P < .001), days readmitted (IRR: 0.14; 95% CI: 0.05-0.37; P < .001), and readmission charges (IRR: 0.11; 95% CI: 0.03-0.46; P = .002). There were 2 deaths among monitored patients compared to 6 for controls; however, this difference was not significant. This pilot study in lung transplant recipients suggests that supplementing postdischarge care with remote monitoring may be useful in preventing readmissions, reducing subsequent inpatient days, and controlling hospital charges. A multicenter, randomized control trial should be conducted to validate these findings.
(© 2020 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
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