Abstract Details

Title To Evaluate the Use of Telemedicine To Provide Intraoperative Neurophysiological Monitoring and Detect Changes in Neurophysiological Responses during Surgery: Observational Study

Topic Clinical Neurophysiology

Presentation(s) P02 - (-)

Poster/Presentation
Number 238

Objective

Background BACKGROUND: During IOM, NPC in Somatosensory evoked potentials(SSEP)and electroencephalography (EEG) if corrected immediately can reduce neurological deficits (ND) after idiopathic scoliosis fusion(ISF)and carotid endartectomies(CEA). IOM can be delivered via telemedicine, where a technologist connects to the physician using a secure connection for real time data interpretation, as supposed to the traditional model of physician in the operating room. Hospitals and insurance payers are unclear if the telemedicine model is different from the traditionally offered model.

Design/Methods DESIGN/METHODS: Observational study conducted between 2004-2012, on 587 and 526 patients who underwent CEA and ISF respectively at various hospitals under in a large health system. Telemedicine was used to provide IOM to all the hospitals in the healthsytem, and in person real time monitoring was provided to the tertiary center. All consecutive patients who underwent the above procedure and whose data could be analyzed were included in the study. Main outcome measures were NPC, ND. Descriptive and regression statistical analysis were performed using SPSS package. Sample size was adequate to detect a significant effect of telemedicine on NPC.

Results RESULTS: The incidence of NPC and ND during and after a CEA were 10.56% and 3.58% respectively. The incidence of NPC and ND during and after ISF were 3.42 % and 0.57% respectively. The use of telemedicine did not increase the adjusted odds of NPC during CEA 1.212 (95% CI 0.69% to 2.12%) or ISF 0.97 (95% CI 0.94 to 1.02). Patients at the tertiary hospital had a higher ND after CEA 2.73 (95% CI 1.16 to 6.3). No difference was noted in ND after ISF.

Conclusions CONCLUSIONS: The use of telemedicine did not have a significant effect on NPC during the CEA or ISF.

Authors/Disclosures
Parthasarathy Thirumala, MD, FAAN (University of Pittsburgh Medical Center) PRESENTER	The institution of Dr. Thirumala has received research support from University of Pittsburgh.
	No disclosure on file
Donald Crammond	No disclosure on file
Fabio M. Iwamoto, MD	No disclosure on file
Miguel D. Habeych, MD, MPH (University of Pittsburgh Medical Center)	No disclosure on file
Jeffery Balzer	No disclosure on file

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