Journal of pediatric surgery · 2025
eHealth in Pediatric Surgery: Impact on Postsurgical Care After Reconstructive Surgery for Anorectal Malformations and Hirschsprung's Disease.
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Wester Fleur Matilda, Johnsson Björn A, Castor Charlotte, Stenström Pernilla
Аннотация
BACKGROUND: To support care after discharge following surgery for anorectal malformations (ARM) and Hirschsprung's disease (HD), an eHealth device was invented, offering families bilateral communication through chat, photo, questionaries and video.
AIM: To explore the impact of eHealth on postoperative patterns of expert consultation, complications and treatment after discharge following surgery for ARM and HD, respectively, compared to conventional care.
METHOD: Interventional prospective case control study observing postoperative care 30 days after discharge after ARM and HD-reconstructions July 2018-July 2023, comparing outcomes between families using the eHealth device versus conventional care.
RESULTS: Consecutively included were 95/141 families (eHealth: ARM n = 48, HD n = 25; respective conventional care: ARM n = 16, HD n = 6). Days to first contact after discharge were fewer for eHealth users, both for ARM 2 vs. 5.5 (p = 0.000) and HD 1 vs 7 (p = 0.000). Days with consultations were more numerous using eHealth: ARM 9 vs 4 (p = 0.000) and HD 12 vs 3.5 (p = 0.001) specifically nurse counseling; ARM 6 versus 1 (p = 0.000) and HD 11 vs 2.5 (p = 0.001). In ARM patients the complication frequency was 23 % (eHealth) versus 50 % (conventional), and the complication severity was lower: Clavien-Madadi 0 (0-4) versus 1 (0-3) (p = 0.040). Treatment adjustments were more frequent for HD patients using eHealth (3 vs. 2 (p = 0.041)).
CONCLUSION: Use of eHealth after ARM respective HD reconstructions implies earlier and more frequent postoperative counseling, especially with nurses. When using eHealth complications were less severe in ARM-patients and treatment adjustments more frequent in the HD patients, compared to those under conventional care.
AIM: To explore the impact of eHealth on postoperative patterns of expert consultation, complications and treatment after discharge following surgery for ARM and HD, respectively, compared to conventional care.
METHOD: Interventional prospective case control study observing postoperative care 30 days after discharge after ARM and HD-reconstructions July 2018-July 2023, comparing outcomes between families using the eHealth device versus conventional care.
RESULTS: Consecutively included were 95/141 families (eHealth: ARM n = 48, HD n = 25; respective conventional care: ARM n = 16, HD n = 6). Days to first contact after discharge were fewer for eHealth users, both for ARM 2 vs. 5.5 (p = 0.000) and HD 1 vs 7 (p = 0.000). Days with consultations were more numerous using eHealth: ARM 9 vs 4 (p = 0.000) and HD 12 vs 3.5 (p = 0.001) specifically nurse counseling; ARM 6 versus 1 (p = 0.000) and HD 11 vs 2.5 (p = 0.001). In ARM patients the complication frequency was 23 % (eHealth) versus 50 % (conventional), and the complication severity was lower: Clavien-Madadi 0 (0-4) versus 1 (0-3) (p = 0.040). Treatment adjustments were more frequent for HD patients using eHealth (3 vs. 2 (p = 0.041)).
CONCLUSION: Use of eHealth after ARM respective HD reconstructions implies earlier and more frequent postoperative counseling, especially with nurses. When using eHealth complications were less severe in ARM-patients and treatment adjustments more frequent in the HD patients, compared to those under conventional care.