Telemedicine medical evaluation of low-risk patients with dengue during an outbreak may be an option in reducing the need for on-site physicians

被引：1

作者：

Pedrotti, Carlos H. S. ^{[1
]}

Accorsi, Tarso A. D. ^{[1
]}

Moreira, Flavio Tocci ^{[1
]}

Lima, Karine De Amicis ^{[1
]}

Kohler, Karen Francine ^{[1
]}

Gaz, Marcus V. B. ^{[2
]}

Chiamolera, Murilo ^{[1
]}

Cunha, Gustavo A. ^{[1
]}

Neto, Ary Serpa ^{[3
]}

Morbeck, Renata A. ^{[1
]}

Cordioli, Eduardo ^{[1
]}

机构：

[1] Hosp Israelita Albert Einstein, Telemed Dept, Sao Paulo, Brazil

[2] Hosp Israelita Albert Einstein, Emergency Dept, Sao Paulo, Brazil

[3] Hosp Israelita Albert Einstein, Intens Care Dept, Sao Paulo, Brazil

来源：

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES | 2022年 / 121卷

关键词：

Telemedicine; Dengue Fever; Emergency Medical Services; Outbreak; Tropical Diseases; Digital Health;

D O I：

10.1016/j.ijid.2022.04.059

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objective: To analyze the effectiveness of telemedicine consultations during an outbreak in reducing the need for face-to-face consultations at a field hospital for patients with dengue. Methods: We performed a retrospective unicentric study between April and May 2015 with 4626 patients (>= 15 years old) who spontaneously sought care at an emergency field hospital (Sao Paulo/Brazil). A nurse initially assessed all patients with dengue through rapid diagnostic testing, automated complete blood count, and risk stratification. During overcrowded situations, a video-based telemedicine consultation was provided as an option to all low-to-moderate risk patients who tested positive. The management was carried out according to current dengue guidelines. The primary end point was a referral to immediate face-to-face medical evaluation. Results: Of all patients suspected of dengue infection, 2003 presented positive testing, 1978 were classified as low-moderate risk, and 267 patients with dengue were evaluated by telemedicine. The mean age was 38.17 +/- 13.7 years (54.6% female). Oral medications were recommended in 169 (63.3%), intravenous hydration or symptomatic drugs in 96 (36%), 252 (94.4%) were discharged after telemedicine assessment, and only 15 (5.6%) were referred to immediate face-to-face medical evaluation. No adverse events were recorded. Conclusion: Telemedicine medical assessment of low-to-moderate risk patients with dengue previously screened by nursing triage is effective in replacing the face-to-face evaluation in a field hospital. Telemedicine may be reinforced in epidemiological outbreak scenarios as a cost-effective strategy for the initial assessment of acute patients. (C) 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

引用

页码：106 / 111

页数：6