TELESCOPE
Trial question
What is the role of tele-critical care in critically ill adult patients?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
45.0% female
55.0% male
N = 17024
17024 patients (7606 female, 9418 male).
Inclusion criteria: adult patients admitted to the ICU.
Key exclusion criteria: admission for other reasons than medical.
Interventions
N=8380 tele-critical care (remote daily multidisciplinary rounds through telemedicine and monthly audit and feedback meetings performed by a board-certified intensivist and provision of evidence-based clinical protocols).
N=8644 usual care (no tele-visit, audit and feedback meetings, or provision of evidence-based clinical protocols).
Primary outcome
Mean intensive care unit length of stay
8.1 days
7.1 days
8.1 days
6.1 days
4.0 days
2.0 days
0.0 days
Tele-critical
care
Usual
care
No significant
difference ↔
No significant difference in mean ICU length of stay (8.1 days vs. 7.1 days).
Secondary outcomes
No significant difference in death in the hospital (41.6% vs. 40.2%; OR 0.93, 95% CI 0.78 to 1.12).
No significant difference in central line-associated bloodstream infections (1.2 per 1,000 central venous catheter-days vs. 0.7 per 1000 central venous catheter-days; IRR 1.15, 95% CI 0.43 to 3.07).
No significant difference in ventilator-associated events (16.3 per 1,000 ventilator-days vs. 17.1 per 1000 ventilator-days; IRR 1.02, 95% CI 0.82 to 1.27).
Conclusion
In adult patients admitted to the ICU, tele-critical care was not superior to usual care with respect to mean ICU length of stay.
Reference
Adriano J Pereira, Danilo T Noritomi, Maura Cristina Dos Santos et al. Effect of Tele-ICU on Clinical Outcomes of Critically Ill Patients: The TELESCOPE Randomized Clinical Trial. JAMA. 2024 Dec 3;332(21):1798-1807.
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