scholarly journals 729. Comparing Length of Stay and Clinical Outcomes for Hospitalized Patients at Bridgeport Hospital who Received Baloxavir Marboxil (BM) or Oseltamivir Phosphate (OP) During the 2018–2019 Influenza Season

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S326-S326
Author(s):  
Arun C Nachiappan ◽  
Wei-Teng Yang
Keyword(s):  
Linear Regression ◽  
Length Of Stay ◽  
Airway Disease ◽  
Hospitalized Patients ◽  
T Test ◽  
Multivariate Linear Regression ◽  
Ethnic Composition ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Viral Mutant

Abstract Background BM has been approved for the management of acute uncomplicated influenza in otherwise healthy individuals between age 12 and 64, and found to have a greater reduction in viremia. The original trial excluded hospitalized patients and those with co-morbidities. Methods This is a single-center, retrospective analysis of hospitalized patients diagnosed with influenza between October 1, 2018 and March 31, 2019. This study excluded those diagnosed before the addition of BM to the hospital formulary; those who were not treated with antivirals, treated before admission, or treated with both antivirals; those younger than 12 years old; and those who remain hospitalized. The relationship between length of stay and antiviral used was ascertained using t-test and multivariate linear regression. Due to heterogeneity in reasons for hospitalization, analysis was stratified by the main reasons for hospitalization. T-test and Wilcoxon’s rank-sum test were used for continuous variables, and Pearson’s chi-squared test was used for categorical variables. The significance level was 0.05. Results The study population (n = 145) has a mean age of 66.5 years; of whom, 43% are male. In terms of patient characteristics, those treated with BM (n = 105) vs. OP (n = 40) were older, less frequently admitted to ICU and of differing ethnic composition. The length of stay was similar in those treated with BM vs. OP in both univariate and multivariate linear regression (5.5 (5.3) vs. 8.2 (11.4) days, P = 0.33). In addition, the length of stay was similar in those treated with BM vs. OP when stratified by reasons for hospitalization: pneumonia/bronchitis (6.6 (7.1) vs. 8.2 (9.2) days, P = 0.43), obstructive airway disease exacerbation (5.5 (4.8) vs. 4.8 (8.0) days, P = 0.56), elderly with multiple co-morbidities (5.0 (4.0) vs. 3.4 (6.8) days, P = 0.63), reactive airway disease (4.1 (4.8) vs. 7.4 (1.5) days, P = 0.27) or congestive heart failure exacerbation (9.8 (9.0) vs. 5.6 (5.0) days, P = 0.43). Conclusion In hospitalized patients with co-morbidities diagnosed with influenza, there was no difference in length of stay in those who received BM vs. OP. This highlights the need to clarify the role of BM in this population, particularly given its comparable symptom reduction, greater cost, and the emergence of PA138T viral mutant. Disclosures All authors: No reported disclosures.

Perianal disease remains an understudied and difficult complication in leukemia patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19016-e19016
Author(s):  
Shreya Gupta ◽  
Nirav Patil ◽  
Emily Steinhagen-Golbig ◽  
Benjamin Kent Tomlinson ◽  
Sharon Stein ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Hospital Cost ◽  
Hospital Costs ◽  
Perianal Abscess ◽  
Lymphocytic Leukemia ◽  
Operative Intervention ◽  
Perianal Disease ◽  
Categorical Variables ◽  
Continuous Variables

e19016 Background: Perianal infection is a rare and poorly understood complication of patients with acute myeloid/lymphocytic leukemia (AML/ALL). With the advancements in oncology, patients are living longer in an immunocompromised state and thus bearing the inherent problems such as infections that arise with it. Perianal infection and its management impacts patients' quality of life as well as interrupts their ongoing oncologic treatment. The optimal treatment strategy for perianal infections in this highly immunocompromised group remains unclear, as does the selection and outcomes of patients for operative intervention. The aim of this study is to identify patient characteristics associated with perianal infection and to delineate outcomes in patients that undergo operative intervention. Methods: The National Inpatient Sample (NIS) database was used to identify hospitalized patients with diagnoses of perianal abscess and AML/ALL between 2007 and 2015. Patient data were weighted to obtain national estimates. Demographics and clinical characteristics were compared between patients with and without perianal disease using Rao-Scott Chi-square test for categorical variables, and weighted simple linear regression for continuous variables. Characteristics and outcomes were compared between patients who underwent operative or non-operative management. Results: There were 12,626 (0.7%) patients with perianal disease among 1,782,778 AML/ALL patient admissions. Patients with perianal disease were more likely to be younger (43.9 (42.5 – 45.3) years, p < 0.001), male (67.4% vs 32.6%, p < 0.001) and white (65.8% vs 54.8%, p < 0.001). Length of stay (18.4 days vs 9 days, p < 0.001) and hospital cost ($54K vs $25K, p < 0.001) were higher in those with perianal disease, but there was no difference in in-hospital mortality (5.5% in those with perianal diseases vs 6.2% in those without, p = 0.150). Greater proportion of patients without perianal disease were discharged to hospice (12.6% patients without perianal disease vs 5.1% patients with perianal disease, p < 0.001). Receiving a surgical intervention did not improve outcomes with respect to in-hospital mortality (5.9% operative vs 5.4 non-operative, p = 0.596), length of stay (20.2 days vs 18.2 days, p = 0.582) or hospital cost ($67K vs $53K, p = 0.525). Conclusions: Perianal disease is a rare but distressing complication in AML/ALL patients associated with longer hospital stays and higher hospital costs. Operative intervention for perianal disease did not reduce rates of in-hospital mortality, length of stay or hospital cost but it does impact the probability of discharge to hospice. Non-operative and operative intervention both remain equivocal in changing the outcomes these patients. Further studies are required to examine these associations and determine best practices for treatment of this condition in this complex patient population.

scholarly journals Better pulmonary function is associated with greater handgrip strength in a healthy Chinese Han population

2020 ◽  
Author(s):  
Liangmei Chen ◽  
Xiaomin Liu ◽  
Qian Wang ◽  
Linpei Jia ◽  
Kangkang Song ◽  
...  
Keyword(s):  
Linear Regression ◽  
Pulmonary Function ◽  
Vital Capacity ◽  
Handgrip Strength ◽  
Multivariate Linear Regression ◽  
Chinese Han Population ◽  
Categorical Variables ◽  
Chinese Han ◽  
Han Population ◽  
Healthy Chinese

Abstract Background: Handgrip strength (HGS) has been widely studied in clinical and epidemiological settings, but the relationship between HGS and pulmonary function is still controversial. This study analyzed pulmonary function and HGS stratified by sex and age in a healthy Chinese Han population, as well as the associations between HGS and pulmonary function parameters. Methods: HGS was measured by a Jamar dynamometer and pulmonary function was tested using a portable spirometer. Frequencies and variables are presented as percentages and means ± standard deviations, respectively. Chi-square tests were used for comparisons of categorical variables, and Student’s t-tests or Mann–Whitney U-tests were used for continuous variables. Pearson correlation and multivariate linear regression models were employed to explore the relationships between HGS and parameters of pulmonary function. The statistical significance was set at p <0.01. Results: Cross-sectional data were available for 1519 subjects (59.0% females, 57.9±13.1 years old). Males had higher average HGS than females (40.2 vs 25.0 kg, p <0.01 ), as well as better pulmonary function. Both HGS and pulmonary function parameters were significantly inversely correlated with age (r=-0.30, p < 0.01). Maximum value of vital capacity, forced expiratory volume in 3 second and forced vital capacity were strongly correlated with HGS among the pulmonary function indices (r=0.72, 0.70 and 0.69, respectively, p <0.001). In multivariate linear regression analysis, HGS and height were positively correlated, while age and pulse pressure were negatively correlated with HGS. Conclusions: Both pulmonary function and HGS were inversely correlated with age, and better pulmonary function was associated with greater handgrip strength.

Abstract WMP12: Does IV tPA Improve Outcomes in Stroke Patients with Large Vessel Occlusions Treated with Intra-arterial Therapy?

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joseph T Ho ◽  
Jason W Tarpley ◽  
Hsin-Fang Li
Keyword(s):  
Ischemic Stroke ◽  
Length Of Stay ◽  
Time Frame ◽  
Large Vessel ◽  
Categorical Variables ◽  
Complication Rates ◽  
Continuous Variables ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Iv Tpa

Introduction: The benefit of endovascular therapy (IAT) for the treatment of emergent large vessel occlusion (ELVO) in stroke patients has been established. However, it is not known whether administration of IV tPA prior to IAT is beneficial in these patients. Methods: A retrospective review of ischemic stroke patients in the Providence Health & Services Get with the Guidelines (GWTG) database was performed from 01/2012 to 05/2016. The analysis was limited to patients who presented within 4.5 hours of last known well time (LKWT) and treatment included any form of IAT. End points were limited to data available in the GWTG database, including discharge mRS, discharge NIHSS, change in NIHSS from admission to discharge, and length of stay. Continuous variables were summarized using means and standard deviation while categorical variables were summarized using frequencies and percentages. To yield a more robust estimate against outliers for the time-related variables, medians and interquartile range (IQR) were computed and assessed using Wilcoxon rank sum tests. Chi-square tests and independent two-sample t-tests were used to evaluate the demographic and outcome differences for categorical and continuous variables, respectively. Results: A total of 10,868 patients with an ischemic stroke diagnosis were found in the specified time frame and presented within 4.5 hours of LKWT. Of these, 461 patients were treated with some form of IAT, 235 received IV tPA prior to IAT, 226 had IAT alone due to contraindication to IV tPA. There was no statistical difference in patient demographics, complication rates, TICI score, discharge NIHSS or mRS at discharge. There was a significantly higher NIHSS on admission (18.3 vs 16.7, p = 0.026), greater improvement in NIHSS (11.6 vs. 7.9, p=0.012), longer door to IAT (146 vs 101.5 min, p < 0.0001), and shorter length of stay (5 vs 6 days, p = 0.016) in the IV tPA group. Conclusions: These data suggest that IV tPA, when administered to eligible patients with ELVO, provided some benefit over IAT alone, even though it delayed IAT. Future prospective randomized trials are planned that may better address this question, but these results underscore the need for retrospective analysis of existing data.

scholarly journals Post operative acute kidney injury in abdominal Surgeries – A retrospective analysis of single center in western India

2021 ◽  
Author(s):  
Bhavin Vasavada ◽  
Hardik Patel
Keyword(s):  
Acute Kidney Injury ◽  
Operative Time ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
T Test ◽  
Categorical Variables ◽  
Western India ◽  
Continuous Variables

ABSTRACTAIMThe aim of our study was to evaluate the incidence and causative factors for acute kidney injury in abdominal surgeries.Material and MethodsAll the abdominal surgeries performed between April 2018 to December 2020, in our institution have been analyzed for acute kidney injury. Acute kidney injury defined according to acute kidney injury network classification. Categorical variables were evaluated by chi-square t-test or fisher’s t-test wherever appropriate and continuous variables by Mann Whitney U test for nonparametric data and student t-test for parametric test after skewness and kurtosis analysis. Statistical analysis was done using SPSS version 23. P< 0.05 was considered statistically significant.ResultsWe performed 402 gastrointestinal and hepatobiliary surgery from April 2018 to December 2020. After exclusion 372 patients were included in the study population. 20 patients (5.37%) were defined as having acute kidney injury according to acute kidney injury network classifications. On univariate analysis acute kidney injury was associated with open surgery (p= 0.003), Intraoperative hypotension (p<0.001), Colorectal surgeries (p<0.0001), Emergency surgery (p=0.028), CDC grade of surgery (p<0.001), increased used to blood products (p=0.001), higher ASA grade (p<0.0001), increased operative time(p<0.0001). On multivariate logistic regression analysis higher ASA grade (p<0.0001) and increased operative time (0.049) independently predicted acute kidney injury. Acute kidney injury was also significantly associated with 90 days mortality. (p= <0.0001).ConclusionPost-operative acute kidney injury was associated with significant mortality in abdominal surgery. Higher ASA grades and increased operative time predicted acute kidney injury.

scholarly journals Assessing the Impact of Patient-Facing Mobile Health Technology on Patient Outcomes: Retrospective Observational Cohort Study (Preprint)

2020 ◽  
Author(s):  
Courtenay R Bruce ◽  
Patricia Harrison ◽  
Tariq Nisar ◽  
Charlie Giammattei ◽  
Neema M Tan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Patient Outcomes ◽  
Mobile Health ◽  
Text Messages ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Readmission Rates ◽  
Orthopedic Surgeons ◽  
Mhealth Technology ◽  
The Impact

BACKGROUND Despite the growth of and media hype about mobile health (mHealth), there is a paucity of literature supporting the effectiveness of widespread implementation of mHealth technologies. OBJECTIVE This study aimed to assess whether an innovative mHealth technology system with several overlapping purposes can impact (1) clinical outcomes (ie, readmission rates, revisit rates, and length of stay) and (2) patient-centered care outcomes (ie, patient engagement, patient experience, and patient satisfaction). METHODS We compared all patients (2059 patients) of participating orthopedic surgeons using mHealth technology with all patients of nonparticipating orthopedic surgeons (2554 patients). The analyses included Wilcoxon rank-sum tests, Kruskal-Wallis tests for continuous variables, and chi-square tests for categorical variables. Logistic regression models were performed on categorical outcomes and a gamma-distributed model for continuous variables. All models were adjusted for patient demographics and comorbidities. RESULTS The inpatient readmission rates for the nonparticipating group when compared with the participating group were higher and demonstrated higher odds ratios (ORs) for 30-day inpatient readmissions (nonparticipating group 106/2636, 4.02% and participating group 54/2048, 2.64%; OR 1.48, 95% CI 1.03 to 2.13; <i>P</i>=.04), 60-day inpatient readmissions (nonparticipating group 194/2636, 7.36% and participating group 85/2048, 4.15%; OR 1.79, 95% CI 1.32 to 2.39; <i>P</i>&lt;.001), and 90-day inpatient readmissions (nonparticipating group 261/2636, 9.90% and participating group 115/2048, 5.62%; OR 1.81, 95% CI 1.40 to 2.34; <i>P</i>&lt;.001). The length of stay for the nonparticipating cohort was longer at 1.90 days, whereas the length of stay for the participating cohort was 1.50 days (mean 1.87, SD 2 vs mean 1.50, SD 1.37; <i>P</i>&lt;.001). Patients treated by participating surgeons received and read text messages using mHealth 83% of the time and read emails 84% of the time. Patients responded to 60% of the text messages and 53% of the email surveys. Patients were least responsive to digital monitoring questions when the hospital asked them to <i>do</i> something, and they were most engaged with emails that <i>did not</i> require action, including informational content. A total of 96% (558/580) of patients indicated high satisfaction with using mHealth technology to support their care. Only 0.40% (75/2059) patients <i>opted-out</i> of the mHealth technology program after enrollment. CONCLUSIONS A novel, multicomponent, pathway-driven, patient-facing mHealth technology can positively impact patient outcomes and patient-reported experiences. These technologies can empower patients to play a more active and meaningful role in improving their outcomes. There is a deep need, however, for a better understanding of the interactions between patients, technology, and health care providers. Future research is needed to (1) help identify, address, and improve technology usability and effectiveness; (2) understand patient and provider attributes that support adoption, uptake, and sustainability; and (3) understand the factors that contribute to barriers of technology adoption and how best to overcome them.

scholarly journals 108. Impact of Accelerate Pheno System in the Management of Gram-Negative Rod Bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S69-S69
Author(s):  
Iaswarya Ganapathiraju ◽  
Amanda Bushman ◽  
Rossana Rosa Espinoza
Keyword(s):  
Length Of Stay ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Culture Collection ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Continuous Variables ◽  
Gram Negative ◽  
Stewardship Program ◽  
The Impact

Abstract Background Early pathogen identification and initiation of appropriate antimicrobial therapy is key in the management of Gram-negative rods (GNR) bloodstream infection (BSI). The Accelerate Pheno System (ACC) has been shown to reduce time to GNR identification compared to traditional culture-based methods. We aimed to determine the impact of ACC on the management of GNR BSI in the setting of a well-established antimicrobial stewardship program (ASP). Table 1 Methods ACC was introduced in our institution on February 2019. Due to issues incorporating ACC, of patients with GNR BSI, 74% had ACC done and 26% had reporting through traditional methods. This allowed for the design of a retrospective cohort study (instead of a pre-post analysis) to evaluate the association of interest. We included adult patients admitted to three affiliated hospitals in Des Moines, Iowa with BSI due to Enterobacteriales from February 2019 to February 2020. Exclusion criteria were Emergency Department visit only and death within 48 hours of blood culture collection. Primary outcomes were length of hospital stay, days to therapy optimization and in-hospital mortality. Continuous variables were compared by non-parametric methods and categorical variables were compared by Chi-square and Fisher-exact test. Logistic regression models were used to calculate odds ratio for the impact of the intervention on therapy optimization. Results A total of 268 patients were analyzed. The median length of stay among patients who had ACC done was 5.2 days (IQR 3.6–8.7) and in those on who ACC was not done it was 5.5 (IQR 3.8–8.9) (p=0.54). No differences in in-hospital mortality were found (p=0.942). Changes in therapy and missed opportunities for optimization according to whether ACC was done are shown in Table 1. Patients who had ACC done had 99% higher odds of de-escalation within 48 hours of blood culture collection compared to patients who did not have it done (95% CI 1.01–3.92; p=0.044). Conclusion In the context of hospitals with baseline short length of stay and a well-established ASP, performing ACC was associated with higher odds of de-escalation within 48 hours of blood culture collection but did not impact length of stay or mortality among patients hospitalized with GNR BSI. Disclosures All Authors: No reported disclosures

706 Frostbite and Drugs of Abuse: Friend or Foe?

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S184-S184
Author(s):  
Anne L Lambert Wagner ◽  
Kiran U Dyamenahalli ◽  
Tyler M Smith ◽  
Patrick Duffy ◽  
Elizabeth J Kovacs ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Drugs Of Abuse ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Homeless Population ◽  
Categorical Variables ◽  
Burn Patients ◽  
Continuous Variables ◽  
Exact Test

Abstract Introduction In the literature, the incidence of alcohol and/or drug use among burn patients ranges from 16.4%-69%. Burn patients with positive toxicology (tox) screens on admission are known to have increased rates of morbidity and mortality. To date little has been published on the effects of positive alcohol and/or drug screens on outcomes in the frostbite population. The objective of this study was to investigate the incidence of drugs and alcohol use in admitted patients with severe frostbite and their association with clinical outcomes. Methods A retrospective cohort study was conducted on 141 frostbite patients admitted to a verified burn center from November 2015 to March 2019. Patients were identified using our burn registry and relevant data was obtained through chart reviews. The primary comparison was between patients with and without a positive tox screen on admission, assessing administration of thrombolytics (tPA) and rates of amputation. Contingency analysis for categorical variables was performed using Fisher’s exact test, while the Mann-Whitney U test was used for continuous variables, reporting, two-tailed p values. Results Tox screens were positive in 77.3% (109) of frostbite patients: 52.5% (74) for marijuana and 56.7% (80) for alcohol. Homelessness accounted for 50.4% (71) and 63.1% (89) were tobacco users. Compared to patients with negative tox screens, significantly higher rates of amputation were found in those using marijuana (p=0.016), other drugs of abuse (p=0.008) and tobacco (p=0.0093). Significantly higher limb salvage rates were found in patients presenting with a negative tox screen (p=0.0077). Only tobacco users had a significantly greater length of stay (p=0.02). 36.2% (51) of the patients received tPA with no difference in administration rates between positive and negative tox screened patients. Patients receiving tPA had significantly lower rates of amputation (p=0.02). 51.8% (73) of admitted patients were homeless, with 83.6% (61) testing tox positive. Both increased hospital length of stay (p=&lt; 0.001) and amputation rates (p=0.0004) were observed in the homeless frostbite population. Conclusions Drugs, alcohol and homelessness significantly impact clinical outcomes in frostbite patients. Homelessness, marijuana, tobacco and other drugs of abuse are associated with significantly higher rates of amputation despite receiving tPA at the same rate. Administration of tPA is significant in lowering amputation rates. Applicability of Research to Practice The association between drugs of abuse, homelessness and frostbite highlight the need for increased preventative efforts especially in the homeless population.

scholarly journals Evaluation of Ki-67 as a Prognostic Marker in Diffuse Large B-Cell Lymphoma—A Single-Center Retrospective Cohort Study

2021 ◽  
Vol 28 (6) ◽  
pp. 4521-4529
Author(s):  
Fabian Huber ◽  
Elisabeth Zwickl-Traxler ◽  
Martin Pecherstorfer ◽  
Josef Singer
Keyword(s):  
Linear Regression ◽  
B Cell ◽  
Treatment Response ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Multivariate Linear Regression ◽  
Categorical Variables ◽  
Ki 67 ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma and prognostic information is essential in finding the right treatment. This study evaluated the prognostic significance of Ki-67 in patients with DLBCL. Methods: Patients with DLBCL, treated with first-line R-CHOP, were retrospectively analyzed in groups of high (>70%) and low (≤70%) Ki-67. Parameters of interest were the international prognostic index (IPI), treatment response, progression-free survival (PFS) and overall survival (OS). A chi-squared test or Fisher’s exact test was conducted to analyze categorical variables. Kaplan–Meier and log-rank tests were applied for survival analyses. Finally, a multivariate linear regression analysis was performed, including gender, Ki-67 ≤ 70% or >70%, IPI and presence of B symptoms. Results: Overall, 58 patients were included. No significant association was found between Ki-67 status and IPI (p = 0.148) or treatment response (p = 0.373). Survival in patients with high Ki-67 was significantly inferior with respect to OS (p = 0.047) but not PFS (p = 0.138). Multivariate linear regression, however, yielded only IPI as a risk factor for OS. Conclusion: Future studies with larger patient cohorts are needed in order to elucidate the prognostic role of Ki-67 in patients with DLBCL treated with R-CHOP.

scholarly journals Assessing the Impact of Patient-Facing Mobile Health Technology on Patient Outcomes: Retrospective Observational Cohort Study

10.2196/19333 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e19333 ◽  
Author(s):  
Courtenay R Bruce ◽  
Patricia Harrison ◽  
Tariq Nisar ◽  
Charlie Giammattei ◽  
Neema M Tan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Patient Outcomes ◽  
Mobile Health ◽  
Text Messages ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Readmission Rates ◽  
Orthopedic Surgeons ◽  
Mhealth Technology ◽  
The Impact

Background Despite the growth of and media hype about mobile health (mHealth), there is a paucity of literature supporting the effectiveness of widespread implementation of mHealth technologies. Objective This study aimed to assess whether an innovative mHealth technology system with several overlapping purposes can impact (1) clinical outcomes (ie, readmission rates, revisit rates, and length of stay) and (2) patient-centered care outcomes (ie, patient engagement, patient experience, and patient satisfaction). Methods We compared all patients (2059 patients) of participating orthopedic surgeons using mHealth technology with all patients of nonparticipating orthopedic surgeons (2554 patients). The analyses included Wilcoxon rank-sum tests, Kruskal-Wallis tests for continuous variables, and chi-square tests for categorical variables. Logistic regression models were performed on categorical outcomes and a gamma-distributed model for continuous variables. All models were adjusted for patient demographics and comorbidities. Results The inpatient readmission rates for the nonparticipating group when compared with the participating group were higher and demonstrated higher odds ratios (ORs) for 30-day inpatient readmissions (nonparticipating group 106/2636, 4.02% and participating group 54/2048, 2.64%; OR 1.48, 95% CI 1.03 to 2.13; P=.04), 60-day inpatient readmissions (nonparticipating group 194/2636, 7.36% and participating group 85/2048, 4.15%; OR 1.79, 95% CI 1.32 to 2.39; P<.001), and 90-day inpatient readmissions (nonparticipating group 261/2636, 9.90% and participating group 115/2048, 5.62%; OR 1.81, 95% CI 1.40 to 2.34; P<.001). The length of stay for the nonparticipating cohort was longer at 1.90 days, whereas the length of stay for the participating cohort was 1.50 days (mean 1.87, SD 2 vs mean 1.50, SD 1.37; P<.001). Patients treated by participating surgeons received and read text messages using mHealth 83% of the time and read emails 84% of the time. Patients responded to 60% of the text messages and 53% of the email surveys. Patients were least responsive to digital monitoring questions when the hospital asked them to do something, and they were most engaged with emails that did not require action, including informational content. A total of 96% (558/580) of patients indicated high satisfaction with using mHealth technology to support their care. Only 0.40% (75/2059) patients opted-out of the mHealth technology program after enrollment. Conclusions A novel, multicomponent, pathway-driven, patient-facing mHealth technology can positively impact patient outcomes and patient-reported experiences. These technologies can empower patients to play a more active and meaningful role in improving their outcomes. There is a deep need, however, for a better understanding of the interactions between patients, technology, and health care providers. Future research is needed to (1) help identify, address, and improve technology usability and effectiveness; (2) understand patient and provider attributes that support adoption, uptake, and sustainability; and (3) understand the factors that contribute to barriers of technology adoption and how best to overcome them.

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