Poster: Tele-ID Consult Services at Academic Medical Centers: Experience and Outcomes During the SARS-CoV-2 Pandemic - Infectious Disease Connect Poster: Tele-ID Consult Services at Academic Medical Centers: Experience and Outcomes During the SARS-CoV-2 Pandemic - Infectious Disease Connect

Academic Literature

Poster: Tele-ID Consult Services at Academic Medical Centers: Experience and Outcomes During the SARS-CoV-2 Pandemic

This poster highlighting tele-ID consults was originally presented at IDWeek 2021, held Oct. 19-23 in Washington, D.C.

Aryn Andrzejewski, M.D.1; Rima C. Abdel-Massih, M.D.2,3; John W. Mellors. M.D.2; Nupur Gupta, DO MPH2
1Division of General Internal Medicine, University of Pittsburgh Medical Center; 2Division of Infectious Disease, University of Pittsburgh Medical Center; 3Infectious Disease Connect, Inc.

Contact: guptan8@upmc.edu

Conclusions

  • Tele-ID is an effective alternative to in-person ID care at academic medical centers.
  • General ID and Transplant ID services were able to evaluate a large proportion of patients with varied ID diagnosis using telemedicine at the onset of the pandemic.
  • Amongst the cases, hospital LOS, 30-day mortality and 30-day readmissions were low.
  • Compared to matched in-person controls, tele-ID demonstrated significantly lower 30-day readmission and shorter ICU LOS.

Background

Questions Addressed

Methods

Characteristic of the Tele-ID Cases (3/1/20 – 5/31/20)

General IDTransplant ID
Number of consults12581
Initial consult location – Floor (#)11161
Average age (years; range)57.8 (20-92)56.8 (24-85)
Female (%)52 (42%)39 (48%)
Caucasian (%)92 (64%)64 (79%)
Average Charlson Comorbidity Index (range)3.2 (0-13)4.4 (0-11)
Heart transplant (#)9
Lung transplant (#)9
Kidney transplant (#)18
Stem cell transplant (#)4
CAR-T (#) 2
Liver transplant (#)12
Multiple transplants (#)7
Pre-transplant evaluation including LVAD (#)18

Characteristic of the Tele-ID Cases (3/1/20 – 5/31/20)

General ID
Average Hospital LOS post-ID consult (days; range)6.26 (-0.11 – 39.9)6.5 (0.08-33.8)
Average ICU LOS (days; range)12 (0-27)7.6 (0-33)
In-hospital mortality (%) 5 (4%)3 (3.7%)
30-day mortality (%) 3 (2.4%)5 (6.2%)
30-day readmission for 1o ID infection (%) 7 (5%)10 (12%)

Primary Outcomes of Matched In-Person Controls to Tele-ID Cases

ControlsCasesStandardized Differences95% CIp-value
Number63365
In-hospital mortality7.7%4.0%0.156-12.8 to 1.9%0.143
30-day mortality9.8%4.9%0.187-15.6 to 0.9%0.080
60-day mortality12.9%8.6%0.139-15.2 to 2.4%0.155
30-day readmission17.3%5.1%0.394-25.0 to -4.9%0.004
ICU admission53.8%46.6%0.145-16.7 to 10.6% 0.665
ICU LOS (hours)269.2118.10.545-365.5 to 81.7%0.002

Broad Range of ID Diagnosis via Telemedicine


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