In a single-institution retrospective study reported in JCO Oncology Practice, Uppal et al found that telemedicine postoperative visits during the COVID-19 pandemic did not result in increased unplanned hospital readmissions vs in-person postoperative visits among patients undergoing elective inpatient surgery for cancer.
As stated by the investigators, “The COVID-19 pandemic has resulted in significant changes in health-care delivery, including the rapid adoption of telemedicine across multiple specialties and practice environments. This includes postoperative visits, despite limited data on outcomes following these telemedicine postoperative visits. We sought to determine whether these types of visits successfully identify and address postoperative complications when compared with in-person postoperative visits.”
Study Details
The study included 535 patients undergoing surgery at The University of Texas MD Anderson Cancer Center between March 2020 and December 2020. The primary outcome measure was unplanned hospital readmission within 90 days.
Key Findings
Of the 535 patients, 98 (18.5%) had an initial telemedicine postoperative visit. No difference in 90-day hospital readmission was observed between telemedicine vs in-person postoperative visits (16.3% vs 16.5%, P = .99). No differences in reasons for readmission were found between groups (including anastomotic leak, acute kidney injury, venous thrombosis, pancreatic leak, wound or other infection, cardiopulmonary complications, bleeding, bowel obstruction, or stroke; all P > .05).
No significant difference between groups was observed in 30-day hospital readmission (11.4% vs 7.1%, P = .29), length of stay during readmission (median = 4.02 vs 5.02 days), or 90-day mortality (0% vs 0.2%).
On multivariate analysis adjusting for demographic and clinical factors, telemedicine postoperative visits were not associated with greater risk of 90-day readmission vs in-person postoperative visits (odds ratio = 0.89, 95% confidence interval = 0.43–1.70, P = .77).
The investigators concluded, “Telemedicine postoperative visit use adopted during the COVID-19 pandemic did not increase risk of readmission when compared with in-person visits following inpatient oncologic surgery. These data can help inform policy on the continued use and application of telemedicine after the pandemic.”
Abhineet Uppal, MD, of the Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, is the corresponding author for the JCO Oncology Practice article.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
