Wearable Technology-A Pilot Study to Define "Normal" Postoperative Recovery Trajectories
Wearable Technology-A Pilot Study to Define "Normal" Postoperative Recovery Trajectories
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DOI：
10.1016/j.jss.2019.06.057
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发表时间：
2019-12-01
影响因子：
2.2
通讯作者：
Robinson, Thomas N.
中科院分区：
文献类型：
--
作者：
Carmichael, Heather;Overbey, Douglas M.;Robinson, Thomas N.
背景：新兴的可穿戴技术有可能量化患者手术前和术后的活动。这项研究的目的是描述普通外科手术后1个月的术后恢复轨迹。材料和方法：患者被安排进行普通的择期手术。术前、术后至少佩戴可穿戴活动器3d，术后28d。术后每天的步数与术前的基线步数进行比较，恢复轨迹报告为患者基线值的百分比。结果：210例患者入选，143例(68%)患者完成随访。患者术前平均每天步行5,342步，术后第一天步数显著减少，包括接受腹股沟疝修补术的患者(为基线步数的22%，P<；0.001)。术后4周，接受微创腹部手术(88%，P=0.035)、开腹手术(%，P=0.002)和胸部手术(32%，P=0.002)的患者，每天的步数没有恢复到基线水平。在术后第一周，所有患者组都表现出快速的台阶恢复，随后恢复到基线的速度较慢。结论：可穿戴式活动监测器提供了有用的技术来量化与术前活动水平相比较的术后每天活动步数的恢复轨迹，其内部效度根据手术类型和入院类型的广泛分类来区分恢复轨迹。活动恢复是以患者为中心的结果，可用于咨询和干预，以提高手术后的活动水平。(C)2019 Elsevier Inc.保留所有权利。
Background: Emerging wearable technology has the potential to quantify both preoperative and postoperative patient activity. The purpose of this study was to characterize postoperative recovery trajectories for 1 mo after common surgical procedures.Materials and methods: Patients included were scheduled for common elective operations. A wearable activity device was worn for at least 3 d preoperatively and 28 d postoperatively. Postoperative steps per day were compared with preoperative baseline steps, with recovery trajectories reported as a percentage of patients' baseline values. Recovery trajectories were compared between groups based on admission type and operation type.Results: Two hundred ten patients were enrolled, and 143 patients (68%) completed follow-up. Patients took a median 5342 steps per day preoperatively and had significantly decreased steps on the first postoperative day, including those undergoing inguinal hernia repair (22% of baseline steps, P < 0.001). Four weeks postoperatively, steps per day had not returned to baseline in patients undergoing minimally invasive abdominal (88% of baseline, P = 0.035), open abdominal (64% of baseline, P = 0.002), and thoracic (32% of baseline, P = 0.002) operations. All groups of patients showed a rapid recovery of steps during the first postoperative week, followed by a slower return to baseline. Recovery trajectories differed based on both admission type and operation type.Conclusions: Wearable activity monitors provide useful technology for quantification of postoperative activity recovery trajectories of steps per day in comparison to preoperative activity levels, with internal validity differentiating recovery trajectories grouping by broad categorization of operation type and by admission type. Activity recovery is a patient-centered outcome that can be used for counseling as well as for intervening to improve activity levels after surgery. (C) 2019 Elsevier Inc. All rights reserved.