A pilot study: The association between physical activity level using by accelerometer and postoperative complications after hepatic resection

Abstract

Recently, accelerometers measuring physical activity level have been available to the public. In the present study, it was examined whether the accelerometer could evaluate postoperative outcomes for 12 patients subjected to hepatic resection from August-November 2016. The association was evaluated between the changing pattern of activity level until the postoperative day (POD) 7 and the occurrence of postoperative complications. The median age of patients was 79 years (range, 58-85). Postoperative complications were identified in 6 patients. The activity level in patients with complications was low from POD 1 and was significantly lower than patients without complications following POD 6. The changing pattern of activity level with all included patients could be divided into the following 3 types: Increase type, bell curve type and flat type. Patients without complications exhibited an accelerated increase of postoperative activity level, categorized as increase type. Bell curve type and flat type demonstrated delay of recovery in postoperative activity levels, and were suggested to be associated with the occurrence of postoperative complications. These findings may provide rationale for larger sample studies to evaluate whether physical activity level measured via accelerometer may be a surrogate marker for postoperative complications.

Wearable devices to monitor recovery after abdominal surgery: scoping review

“…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 . Patients with postoperative delirium had similar mobilization in the early postoperative interval and had lower physical activity at 1 month after surgery 83 .…”

“…Iida et al . investigated the impact of different recovery trajectories following hepatectomy, classifying patients into ‘steady increase’, ‘bell curve’, and ‘flat’ categories 78 , 79 . Patients with a ‘steady increase’ had a low risk of complications.…”

Relationship Between Mobile Digital Sensor Monitoring and Perioperative Outcomes: Systematic Review

“…Finally, 1 study followed patients after lumbar spine fusion, and 1 evaluated patients following open vascular bypass grafting of the extremities. The largest study cohort consisted of 226 patients [ 25 ], while the smallest included 11 patients [ 16 ]. Surgical outcome variables were author defined and included Clavien-Dindo graded surgical complications, pulmonary and cardiovascular complications, sepsis, hospital readmission, and SNF discharge.…”

“…As reported in Multimedia Appendix 3, a total of 10 of 11 studies evaluated physical activity. Of these, 7 specified the evaluation of activity and perioperative outcomes as a specific aim [15][16][17][18][19][20][21]. A total of 3 studies evaluated complications but did not mention if it was a primary or secondary end point [22][23][24].…”

“…Of the included studies, 8 were rated as low quality by GRADE criteria secondary to major differences between surgical groups, low participant number, high variability in results, and perception of bias (Multimedia Appendix 3) [13,[15][16][17][18][19][20]22,23]. Two studies were rated as moderate quality due to medically homogenous participants and the lack of preoperative ambulatory information [21,24].…”