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Remote Symptom Moni...
Remote Symptom Monitoring with Clinical Alerts Following Mastectomy: Do Early Symptoms Predict 30-Day Surgical Complications
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Chu, Jacqueline J. (author)
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Tadros, Audree B. (author)
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Vingan, Perri S. (author)
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Assel, Melissa J. (author)
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McCready, Taylor M. (author)
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Vickers, Andrew J. (author)
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- Carlsson, Sigrid, 1982 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology
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Morrow, Monica (author)
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Mehrara, Babak J. (author)
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Stern, Carrie S. (author)
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Pusic, Andrea L. (author)
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Nelson, Jonas A. (author)
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(creator_code:org_t)
- 2024
- 2024
- English.
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In: ANNALS OF SURGICAL ONCOLOGY. - 1068-9265 .- 1534-4681.
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https://doi.org/10.1...
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Abstract
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- Background. Electronic patient-reported outcome measures (ePROMs) for real-time remote symptom monitoring facilitate early recognition of postoperative complications. We sought to determine whether remote, electronic, patient-reported symptom-monitoring with Recovery Tracker predicts 30-day readmission or reoperation in outpatient mastectomy patients. Methods. We conducted a retrospective review of breast cancer patients who underwent outpatient (< 24-h stay) mastectomy with or without reconstruction from April 2017 to January 2022 and who received the Recovery Tracker on Days 1-10 postoperatively. Of 5,130 patients, 3,888 met the inclusion criteria (2,880 mastectomy with immediate reconstruction and 1,008 mastectomy only). We focused on symptoms concerning for surgical complications and assessed if symptoms reaching prespecified alert levels-prompting a nursing call-predicted risk of 30-day readmission or reoperation. Results. Daily Recovery Tracker response rates ranged from 45% to 70%. Overall, 1,461 of 3,888 patients (38%) triggered at least one alert. Most red (urgent) alerts were triggered by pain and fever; most yellow (less urgent) alerts were triggered by wound redness and pain severity. The 30-day readmission and reoperation rates were low at 3.8% and 2.4%, respectively. There was no statistically significant association between symptom alerts and 30-day reoperation or readmission, and a clinically relevant increase in risk can be excluded (odds ratio 1.08; 95% confidence interval 0.8-1.46; p = 0.6). Conclusions. Breast cancer patients undergoing mastectomy with or without reconstruction in the ambulatory setting have a low burden of concerning symptoms, even in the first few days after surgery. Patients can be reassured that symptoms that do present resolve quickly thereafter.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
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- ref (subject category)
- art (subject category)
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- By the author/editor
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Chu, Jacqueline ...
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Tadros, Audree B ...
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Vingan, Perri S.
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Assel, Melissa J ...
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McCready, Taylor ...
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Vickers, Andrew ...
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show more...
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Carlsson, Sigrid ...
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Morrow, Monica
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Mehrara, Babak J ...
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Stern, Carrie S.
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Pusic, Andrea L.
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Nelson, Jonas A.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
- Articles in the publication
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ANNALS OF SURGIC ...
- By the university
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University of Gothenburg