Wearable technology and the association of perioperative activity level with 30-day readmission among patients undergoing major colorectal surgery

Kane, William J.; Hassinger, Taryn E.; Myers, Emma L; Chu, David L.; Charles, Ashley N; Hoang, Sook C.; Friel, Charles M.; Thiele, Robert H.; Hedrick, Traci L.

doi:10.1007/s00464-021-08449-3

Cited by 19 publications

(48 citation statements)

References 34 publications

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“…Multiple studies showed that greater postoperative physical activity was correlated with shorter length of stay 28 , 58 , 73–75 , and a reduced risk of readmission following discharge 15 , 73 , 76 , 77 . Higher postoperative step counts were associated with a lower risk of complications 30 , 72–74 , 78–81 , faster gastrointestinal recovery 73 , and lower long-term skeletal muscle loss 82 .…”

Section: Resultsmentioning

confidence: 99%

“…Patients with postoperative delirium had similar mobilization in the early postoperative interval and had lower physical activity at 1 month after surgery 83 . Of these studies aiming to predict postoperative outcomes with postoperative physical activity measurements, only four accounted for patients’ baseline preoperative physical activity levels 76 , 80 , 81 , 83 . No studies analysed physical activity data in ‘real time’ to monitor recovery or identify complications.…”

Section: Resultsmentioning

confidence: 99%

“…Normalizing a patient’s postoperative physical activity relative to their baseline may be a more appropriate method for risk assessment 76 , 80 , and the characterization of mobilization ‘patterns’ as suggested by Iida et al . may offer more detailed insights into the prediction of specific postoperative complications 78 , 79 .…”

Section: Discussionmentioning

confidence: 99%

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Wearable devices to monitor recovery after abdominal surgery: scoping review

Wells

Penfold

et al. 2022

BJS Open

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Background Wearable devices have been proposed as a novel method for monitoring patients after surgery to track recovery, identify complications early, and improve surgical safety. Previous studies have used a heterogeneous range of devices, methods, and analyses. This review aimed to examine current methods and wearable devices used for monitoring after abdominal surgery and identify knowledge gaps requiring further investigation. Methods A scoping review was conducted given the heterogeneous nature of the evidence. MEDLINE, EMBASE, and Scopus databases were systematically searched. Studies of wearable devices for monitoring of adult patients within 30 days after abdominal surgery were eligible for inclusion. Results A total of 78 articles from 65 study cohorts, with 5153 patients were included. Thirty-one different wearable devices were used to measure vital signs, physiological measurements, or physical activity. The duration of postoperative wearable device use ranged from 15 h to 3 months after surgery. Studies mostly focused on physical activity metrics (71.8 per cent). Continuous vital sign measurement and physical activity tracking both showed promise for detecting postoperative complications earlier than usual care, but conclusions were limited by poor device precision, adherence, occurrence of false alarms, data transmission problems, and retrospective data analysis. Devices were generally well accepted by patients, with high levels of acceptance, comfort, and safety. Conclusion Wearable technology has not yet realized its potential to improve postoperative monitoring. Further work is needed to overcome technical limitations, improve precision, and reduce false alarms. Prospective assessment of efficacy, using an intention-to-treat approach should be the focus of further studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Wearable devices to monitor recovery after abdominal surgery: scoping review

Wells

Penfold

et al. 2022

BJS Open

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“…19 Many modern consumer wearables employ triaxial accelerometers to provide an estimate of select parameters of physical activity, such as step count, calorie expenditure, and distance traveled. 20,21 Emerging research across various surgical populations has identified that these parameters may predict the risk of readmission, 10-12,22,23 hospital length of stay, 13,24-28 postoperative complications, 11,12,14 and patient-reported outcome measures 15,16,29-33 (Supplemental Table S1, available online), though the strength of evidence supporting these findings is mixed. Inpatient monitoring via consumer wearables potentially permits indirect assessment of factors contributing to diminished mobilization, such as postoperative pain, thereby prompting tailored interventions.…”

Section: Assessment and Encouragement Of Mobilizationmentioning

confidence: 99%

Consumer Wearables for Patient Monitoring in Otolaryngology: A State of the Art Review

Somani

Chiu

et al. 2021

Otolaryngol.--head neck surg.

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Objective Consumer wearables, such as the Apple Watch or Fitbit devices, have become increasingly commonplace over the past decade. The application of these devices to health care remains an area of significant yet ill-defined promise. This review aims to identify the potential role of consumer wearables for the monitoring of otolaryngology patients. Data Sources PubMed. Review Methods A PubMed search was conducted to identify the use of consumer wearables for the assessment of clinical outcomes relevant to otolaryngology. Articles were included if they described the use of wearables that were designed for continuous wear and were available for consumer purchase in the United States. Articles meeting inclusion criteria were synthesized into a final narrative review. Conclusions In the perioperative setting, consumer wearables could facilitate prehabilitation before major surgery and prediction of clinical outcomes. The use of consumer wearables in the inpatient setting could allow for early recognition of parameters suggestive of poor or declining health. The real-time feedback provided by these devices in the remote setting could be incorporated into behavioral interventions to promote patients’ engagement with healthy behaviors. Various concerns surrounding the privacy, ownership, and validity of wearable-derived data must be addressed before their widespread adoption in health care. Implications for Practice Understanding how to leverage the wealth of biometric data collected by consumer wearables to improve health outcomes will become a high-impact area of research and clinical care. Well-designed comparative studies that elucidate the value and clinical applicability of these data are needed.

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“…Wearable technologies and smart phone applications can also alert clinicians to risk of readmission. Kane et al found that failure to achieve baseline step counts was associated with risk of readmission in colorectal surgery patients ( 37 ). A meta-analysis of studies in mobile health applications used by postoperative patients demonstrated reduced emergency department visits and hospital admissions ( 38 ).…”

Section: Introductionmentioning

confidence: 99%

Gamification for Machine Learning in Surgical Patient Engagement

2022

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Patients and their surgeons face a complex and evolving set of choices in the process of shared decision making. The plan of care must be tailored to individual patient risk factors and values, though objective estimates of risk can be elusive, and these risk factors are often modifiable and can alter the plan of care. Machine learning can perform real-time predictions of outcomes, though these technologies are limited by usability and interpretability. Gamification, or the use of game elements in non-game contexts, may be able to incorporate machine learning technology to help patients optimize their pre-operative risks, reduce in-hospital complications, and hasten recovery. This article proposes a theoretical mobile application to help guide decision making and provide evidence-based, tangible goals for patients and surgeons with the goal of achieving the best possible operative outcome that aligns with patient values.

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Wearable technology and the association of perioperative activity level with 30-day readmission among patients undergoing major colorectal surgery

Cited by 19 publications

References 34 publications

Wearable devices to monitor recovery after abdominal surgery: scoping review

Wearable devices to monitor recovery after abdominal surgery: scoping review

Consumer Wearables for Patient Monitoring in Otolaryngology: A State of the Art Review

Gamification for Machine Learning in Surgical Patient Engagement

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