Impact of telehealth postoperative care on early outcomes following esophagectomy

• Published in: The Journal of thoracic and cardiovascular surgery
• Main Authors: Xiao, Karren, Bolger, Jarlath C., Allison, Frances, Darling, Gail E., Yeung, Jonathan C.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 09.02.2024
• Subjects: COVID pandemic; esophagectomy; telehealth care; COVID pandemic; esophagectomy; telehealth care; ED
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/j.jtcvs.2024.02.005

To address the short-term clinical outcomes of patients postesophagectomy who underwent telehealth care following surgery. The primary objective was to compare the frequency of emergency department admission between telehealth and in-person cohorts. Secondary objectives included comparing the frequency of endoscopies and clinic visits, as well as reasons for emergency department admission. We conducted a retrospective cohort study to assess the clinical outcomes of patients who underwent esophagectomy between March 2018 and May 2022. Patients attending telehealth (phone or video call) surgical follow-up visits, largely due to the COVID-19 pandemic, were compared with a pre-COVID cohort of patients attending standard in-person care. Demographic data, clinical and disease characteristics, and hospital visit data within 6 months of operation were collected. This included surgical clinic visits, endoscopies, and emergency department admissions. There were 168 patients who underwent esophagectomy and had follow-up care between March 2018 and May 2022; 76 telehealth and 92 in-person. Patients attending telehealth appointments had significantly fewer emergency department admissions (0.45 vs 0.79, P = .037) and more endoscopy visits (1.37 vs 0.91, P = .020) compared with patients attending in-person visits. The number of follow-up surgical clinic visits did not differ between the groups. The most frequent reasons for emergency visits for the telehealth cohort included dysphagia, feeding-tube problems, and failure to thrive. For the in-person cohort, feeding-tube complications, inflammation/infection, and failure to thrive were the most common reasons. A program of virtual follow-up, with integrated in person visits and endoscopy as required, is feasible and safe for following patients postesophagectomy. [Display omitted]