Association of Daily Step Count and Postoperative Surgical Complications Among All of Us Research Participants

Abstract

BackgroundThe association between preoperative wearable device step counts and surgical outcomes has not been examined using commercial devices linked to electronic health records (EHR) at a population level. This study measured the association between daily preoperative step counts and postoperative complications.Study DesignData was obtained using the All of Us (AOU) Research program, a nationwide initiative to collect EHR and health-related data from the population. Included were patients who underwent a surgical procedure included in the National Surgical Quality Improvement Program (NSQIP) targeted procedures dataset. Excluded were patients without complete perioperative FitBit data. Primary outcome was the development of a postoperative complication. All analyses were performed in the AOU researcher workbench.ResultsOf 27,150 patients who underwent a surgical procedure, 475 participants with preoperative wearable data were included. 74.7% were female and 85.2% were White. The average age was 57.2 years. The overall rate of postoperative complications was 12.6%. Patients averaging fewer than 7,500 daily steps were at increased odds for developing a postoperative complication (OR 1.83, 95% CI [1.01, 3.31]). Following adjustment for age, sex, race, comorbid disease, body mass index (BMI), and relative procedure risk, patients with a baseline average steps/day < 7,500 were at increased odds for postoperative complication (aOR = 2.06, 95% CI [1.05, 4.06]).ConclusionsThis study found an increase in overall postoperative complication rate in patients recording lower average preoperative step counts. Patients with a baseline of less than 7,500 steps per day had increased odds of postoperative complications in this cohort. This population data supports the use of wearable devices for surgical risk stratification and suggests step count may help to measure preoperative fitness.