Intensified and Standardized Digital Communication with Cystectomy Patients as a Potentially Simple and Effective Modality for Early Detection of Postoperative Complications: Results from a Pilot Study
| Autor: | Jean-Luc Zehnder, Anirban P. Mitra, Philipp M. Huber, Frédéric D. Birkhäuser, Pascal Zehnder, Felix Moltzahn, Sebastian Flückiger, Daniel Hasler |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Cellphone-based health care application business.industry Nausea Urology medicine.medical_treatment Psychological intervention Vital signs lcsh:Diseases of the genitourinary system. Urology lcsh:RC870-923 lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens lcsh:RC254-282 Bladder Cancer Postoperative surveillance Cystectomy Postoperative complications Radical cystectomy Weight loss Intervention (counseling) Emergency medicine Health care medicine Stage (cooking) medicine.symptom business |
| Zdroj: | European Urology Open Science European Urology Open Science, Vol 22, Iss, Pp 3-8 (2020) |
| ISSN: | 2666-1683 |
| Popis: | Background Postoperative readmission rates following radical cystectomy remain significant. Early identification of emerging complications could potentially allow for immediate institution of therapy. Objective To intensify postoperative patient-physician communication via a cellphone-based health care application (CHA) and to evaluate its potential for early detection of complications. Design, setting, and participants This was a pilot study involving 18 radical cystectomy patients. During the first 30 d, patients received a push cellphone notification twice a week requesting data input into the CHA. This was reduced to once a week from day 31 to day 90. De-identified recorded data were reviewed by the surgeon involved. If deemed necessary, patients were contacted by the surgeon via telephone to obtain more detailed clinical information. Outcome measurements and statistical analysis Descriptive statistics were used. Results and limitations Of the 18 patients enrolled, all completed the 90-d reporting period. On two occasions, interventions were necessary on the basis of data recorded on the CHA. One neobladder patient was given antibiotic therapy for pyelonephritis. Another patient reported weight loss and nausea with clinical suspicion of metabolic acidosis, and his sodium bicarbonate and fluid intake were increased. Limitations include the small number of cases from a single low-volume center. Conclusions CHA-based monitoring of clinical parameters within the crucial 90-d postoperative period following radical cystectomy provides meaningful information. In this pilot study, two potential readmissions were possibly avoided on the basis of recorded basic vital signs and early intervention. Patient summary Besides regular clinic follow-up visits after radical cystectomy, additional aids such as a cellphone-based health care application can provide treating physicians with relevant clinical information and may help to identify imminent deviations from normal postoperative recovery at an early stage. Take Home Message Besides regular clinical follow-up after radical cystectomy, an additional aid such as a health care app can provide relevant clinical information and may help in identifying imminent deviations from the normal postoperative course at an early stage. |
| Databáze: | OpenAIRE |
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