RT Journal Article
SR Electronic
T1 Can a mobile app technology reduce emergency department visits and readmissions after lung resection? A prospective cohort study
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP E798
OP E804
DO 10.1503/cjs.000122
VO 65
IS 6
A1 Minervini, Fabrizio
A1 Taylor, Jenelle
A1 Hanna, Waël C.
A1 Agzarian, John
A1 Hughes, Kristen
A1 Pinkney, Patrice
A1 Lopez-Hernandez, Yessica
A1 Coret, Michal
A1 Schneider, Laura
A1 Finley, Christian
A1 Rushton, Jacob
A1 Tran, Anna
A1 Shargall, Yaron
YR 2022
UL http://canjsurg.ca/content/65/6/E798.abstract
AB Background: Emergency department (ED) visits and readmissions after thoracic surgery are a major health care problem. We hypothesized that the addition of a novel post-discharge mobile app specific to thoracic surgery to an existing home care program would reduce ED visits and readmissions compared to a home care program alone.Methods: We conducted a prospective cohort study of patients undergoing major lung resection for malignant disease between November 2016 and May 2018. Patients received either home care alone (control group) or home care plus a patient-input mobile app (intervention group). Primary outcomes were 30-day readmission and ED visit rates. Secondary outcomes included reasons for ED visits and readmissions, perioperative complications, 30-day mortality, anxiety (assessed with the Generalized Anxiety Disorder-7 Scale [GAD-7]) and app-related adverse events. We compared outcomes between the 2 groups, analyzing the data on an intention-to-treat basis.Results: Despite the greater number of open surgery and anatomic resections in the intervention cohort, patients in that group were less likely than those in the control group to visit the ED within 30 days of discharge (24.0% v. 38.8%, p = 0.02). Thirty-day readmission rates were similar between the intervention and control groups (10.1% v. 12.2%, p = 0.6). In a subset of patients, there was no difference between the 2 groups in the proportion of patients with a GAD-7 score of 0 (control group 79.8%, intervention group 79.5%, p = NS), which indicated a similar absence of postdischarge anxiety and depression symptoms in the 2 cohorts.Conclusion: The addition of a mobile app to a home care program after thoracic surgery was associated with a reduced frequency of ED visits, in spite of the higher proportions of thoracotomies and anatomic resections in the app cohort. More studies are needed to evaluate the full effect of this new, emerging technology.