Acceptance of mHealth among health professionals: a case study on anesthesia practitioners

The Internet, Apps, and the Anesthesiologist

Modern anesthesia continues to be impacted in new and unforeseen ways by digital technology. Combining portability and versatility, mobile applications or "apps" provide a multitude of ways to enhance anesthetic and peri-operative care. Research suggests that the uptake of apps into anesthetic practice is becoming increasingly routine, especially amongst younger anesthetists brought up in the digital age. Despite this enthusiasm, there remains no consensus on how apps are safely and efficiently integrated into anesthetic practice. This review summarizes the most popular forms of app usage in anesthesia currently and explores the challenges and opportunities inherent in implementing app use in anesthesia, with an emphasis on a practical approach for the modern anesthetist.

Validation of a simple risk stratification tool for COVID-19 mortality

Risk prediction is an essential part of clinical care, in order to allocate resources and provide care appropriately. During the COVID-19 pandemic risk prediction became a matter of political and public debate as a major clinical need to guide medical and organizational decisions. We previously presented a simplified risk stratification score based on a nomogram developed in Wuhan, China in the early phase of the pandemic. Here we aimed to validate this simplified risk stratification score in a larger patient cohort from one city in Austria. Age, oxygen saturation, C-reactive protein levels and creatinine levels were used to estimate the in-hospital mortality risk for COVID-19 patients in a point based score: 1 point per age decade, 4 points for oxygen saturation <92%, 8 points for CRP > 10 mg/l and 4 points for creatinine > 84 μmol/l. Between June 2020 and March 2021, during the “second wave” of the pandemic, 1,472 patients with SARS-CoV-2 infection were admitted to two hospitals in Graz, Austria. In 961 patients the necessary dataset to calculate the simplified risk stratification score was available. In this cohort, as in the cohort that was used to develop the score, a score above 22 was associated with a significantly higher mortality (p < 0.001). Cox regression confirmed that an increase of one point in the risk stratification score increases the 28-day-mortality risk approximately 1.2-fold. Patients who were categorized as high risk (≥22 points) showed a 3–4 fold increased mortality risk. Our simplified risk stratification score performed well in a separate, larger validation cohort. We therefore propose that our risk stratification score, that contains only two routine laboratory parameter, age and oxygen saturation as variables can be a useful and easy to implement tool for COVID-19 risk stratification and beyond. The clinical usefulness of a risk prediction/stratification tool needs to be assessed prospectively (https://www.cbmed.at/covid-19-risk-calculator/).