Lower limb arterial disease, caused by vascular obstruction, can lead to amputation and is often associated with coronary artery disease and stroke. The 5-year survival rate for these patients is only 20%. Research from National Taiwan University Hospital (NTUH) has found that real-time synchronized telemedicine care significantly improves cardiovascular control and reduces the risk of stroke in these patients. This approach has now been incorporated into the American Heart Association's (AHA) guidelines for the care of lower limb arterial disease, published in May.
The guideline references a 2021 paper by NTUH's Dr. Jen-Kuang Lee, published in the Journal of Medical Internet Research, which highlighted the benefits of telemedicine for patients with lower limb arterial disease. The guideline underscores the complexity and high comorbidity of these patients, often leading to major cardiovascular events. Long-term follow-up and treatment are essential, and telemedicine provides comprehensive, real-time care that addresses the shortcomings of current home care practices.
Dr. Lee explained that besides preventing amputations, patients with lower limb arterial disease are prone to severe conditions such as myocardial infarction and stroke. Telemedicine allows patients to monitor their physiological data at home using equipment provided by the hospital, such as ECG systems, and to upload images of their wounds for AI-assisted diagnosis.
Dr. Lee recounted the case of an 83-year-old male patient with peripheral vascular disease, who faced the prospect of below-knee amputation due to gangrene in his toes. After joining the telemedicine program, the patient received complete and immediate care from the team, resulting in the amputation being limited to just his toes. The patient expressed his gratitude, saying, "Thank you to the medical team for saving my leg."
The NTUH Telemedicine Care Center, with 14 years of experience and data from nearly 7,000 patients, has shown that telemedicine care reduces the amputation rate from 18% to 10%, the mortality rate from 29% to 14%, and cuts the average hospital stay in half. Patient care satisfaction has increased from 95.7% to 97.5%.
NTUH President Ming-Shiang Wu emphasized that telemedicine transcends time and space constraints, providing essential medical services. Its importance was particularly evident during the COVID-19 pandemic. NTUH established its Telemedicine Care Center 14 years ago, utilizing wearable devices and real-time transmission technology to enhance healthcare processes and improve patient health. For patients, it effectively acts as a virtual ward, offering an optimal solution for comprehensive care.
Resource (mandarin): 臺大醫院下肢動脈遠距照護 列美標準照護指引
