COVID-19 and telehealth in the intensive care unit setting: a survey.

BACKGROUND: Coronavirus disease (COVID-19) has led to changes in how healthcare is delivered. Here, through the administration of surveys, we evaluated telehealth use and views in US intensive care units (ICUs) during the pandemic. METHODS: From June 2020 to July 2021, voluntary, electronic surveys were provided to ICU leaders of Johns Hopkins Medical Institution (JHMI) hospitals, members of the Neurocritical Care Society (NCS) who practice in the US, and Society of Critical Care Medicine (SCCM) members practicing adult medicine. RESULTS: Response rates to our survey were as follows: 18 of 22 (81.8%) JHMI-based ICU leaders, 22 of 2218 (1.0%) NCS members practicing in the US, and 136 of 13,047 (1.0%) SCCM members. COVID-19 patients were among those cared for in the ICUs of 77.7, 86.4, and 93.4% of respondents, respectively, in April 2020 (defined as the peak of the pandemic). Telehealth technologies were used by 88.9, 77.3, and 75.6% of respondents, respectively, following the start of COVID-19 while only 22.2, 31.8, and 43.7% utilized them prior. The most common telehealth technologies were virtual meeting software and telephone (with no video component). Provider, nurse, and patient communications with the patient's family constituted the most frequent types of interactions utilizing telehealth. Most common reasons for telehealth use included providing an update on a patient's condition and conducting a goals of care discussion. 93.8-100.0% of respondents found telehealth technologies valuable in managing patients. Technical issues were noted by 66.7, 50.0, and 63.4% of respondents, respectively. CONCLUSIONS: Telehealth use increased greatly among respondents following the start of COVID-19. In US ICUs, telehealth technologies found diverse uses during the pandemic. Future studies are needed to confirm our findings.

Vascular Surgery Kidney Injury Predictive Score: A Historical Cohort Study.

OBJECTIVES: To develop a risk-prediction model for acute kidney injury (AKI) in patients undergoing vascular surgery. DESIGN: A retrospective cohort study. SETTING: A tertiary referral center. PARTICIPANTS: Participants included 845 adult patients who underwent vascular surgery between January 3, 2003, and May 29, 2008. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The median age of patients was 72 years (interquartile range 65-80 years), and 653 patients (77%) were male. AKI developed in 258 (30.5%) patients. Patients with AKI had lower estimated glomerular filtration rates (60±21 v 72±21, p<0.001), were older (73 [68-78] years v 71 [65-80] years, p = 0.01), had a higher prevalence of hypertension (81% v 73%, p = 0.02), and were more likely to undergo emergency surgery (5% v 2%, p = 0.02). Patients with AKI also received more diuretics (p<0.001) and ß-blockers (p = 0.003) prior to surgery. The multivariate AKI risk-prediction model with preoperative variables (estimated glomerular filtration rate, previous vascular interventions, use of preoperative diuretics and ß-blockers, and emergency surgery) showed an area under the receiver operating characteristic curve of 0.67 (95% confidence interval, 0.628-0.710); a model with additional intraoperative variables (procedure duration, fluid balance, and plasma and platelet transfusion) had an area under the receiver operating characteristic curve of 0.72 (95% confidence interval, 0.685-0.760). CONCLUSIONS: As AKI is a very common complication after vascular surgery, a risk-prediction model was derived to assess the likelihood of postoperative AKI. If validated in an independent cohort, this model may be used to facilitate targeted interventions in vascular surgery patients at high risk for AKI.

Asia-Pacific Hematology Consortium Report on approach to multiple myeloma. Survey results from the 6th International Hematologic Malignancies Conference: Bridging the Gap 2015, Beijing, China.

The Asia-Pacific Hematology Consortium (APHCON), in partnership with MDRingTM, a mobile global physician education network, has initiated a detailed longitudinal study of physician knowledge and practice preferences in the Asia-Pacific sphere. The first dataset comes from a series of surveys answered by delegates at the APHCON Bridging The Gap (BTG) conference in Beijing in January, 2015. In this report we present our findings regarding diagnosis and treatment of multiple myeloma (MM). We aim to create a conduit for physicians in this region to share their experiences with the rest of the world, to identify areas of consensus and best practices, and to highlight opportunities for improvement in communication, education and patient care.