Purpose
Evaluate a virtual platform to track percutaneous drains in real-time to guide IR drain management during phase I (pre-resurgence) and II (resurgence) of the COVID-19 pandemic.
Materials and Methods
A prospective review of all patients undergoing percutaneous drain placement in IR between March and August 2020 was carried out (n = 98). All patients undergoing percutaneous drainage of a fluid collection with eventual discharge to home were included. Those with indwelling tubes at the end of the study period were excluded (n = 20). A total of 78 drains met inclusion criteria. Patients were instructed on how to utilize the virtual log, which included daily drain outputs, presence/absence of leakage (spontaneous or with flushing), and daily body temperature prior to discharge. This virtual log was accessed by patients through the patient portal via a computer or smart phone and was integrated into the electronic medical record for provider review. A Fisher’s exact test was used to compare percent compliance during phase I and phase II. Unpaired two-tailed t-tests were used to compare mean time to tube removal (mTTR).
Results
Compliance with virtual drain log usage was 30.8% [24/78] with no significant difference between phase I and II (P > 0.05). mTTR ± SE was 44.7 ± 7.1 days in patients who did not use the virtual log, compared with 36.9 ± 8.2 days in patients who did use the virtual log with a difference of 7.8 days, which did not reach statistical significance (P > 0.05). There was a statistically significant difference of 30.6 days in overall mTTR between phase I and phase II (P = 0.007) with a significant difference of 34.5 days between phase I and phase II in the sub-group that did not use the virtual drain log (P = 0.018). There was no significant difference between phase I and phase II in the group that used the virtual drain log.
Conclusions
This study demonstrates a significantly increased mTTR in patients who did not use a virtual drain log during the most restrictive phase of the COVID-19 pandemic. Virtual platforms to guide clinical decision making are important tools in health care delivery, particularly with increasing utilization of telehealth services.