Fitbit step counts during inpatient recovery from cancer surgery as a predictor of readmission

Abstract

Background Postoperative ambulation is encouraged to promote timely recovery but is rarely monitored objectively or examined as a predictor of clinical outcomes, despite growing availability of wearable devices that allow passive quantification and remote real-time monitoring of the number of steps taken during recovery. Purpose To determine whether the number of steps taken during inpatient recovery predicts 30- and 60-day readmission risk after metastatic cancer surgery. Methods Patients diagnosed with metastatic peritoneal cancer and scheduled for surgical resection were enrolled in this observational cohort study at their preoperative clinic visit. Fitbits were placed on patients’ wrists upon transfer from the ICU following surgery and worn for the duration of their inpatient stay. Information about hospital readmission was extracted from electronic medical records. Results Seventy-one patients participated in the study (mean age = 57.14, range = 31–80 years; 42% female; 51% diagnosed with appendiceal cancer). Mean steps per day were calculated for each participant over the entire inpatient recovery period (mean stay = 12.12 days, 4–37 days). Readmission within 30 and 60 days was medically indicated for 34% and 39% of patients, respectively. After statistically adjusting for age, body mass index, comorbidity, and length of postoperative stay, higher mean steps per day predicted lower 30-day and 60-day readmission risk. Conclusions Higher Fitbit step counts during inpatient recovery predicted lower risk of 30- and 60-day readmission after surgery for metastatic peritoneal cancer. Results suggest that passively monitoring peri-operative ambulation may identify patients at risk for readmission and highlight opportunities for behavioral intervention.

Harnessing consumer smartphone and wearable sensors for clinical cancer research

“…During outpatient chemoradiation therapy, lower levels of activity as measured with Garmin devices were associated with greater hospitalization risk, lower likelihood of completing treatment without delays, and shorter survival 27 , 28 . In a sample of 71 patients undergoing surgery for advanced abdominal cancer, lower Fitbit step counts during inpatient recovery were associated with greater risk of unplanned 30- and 60-day hospital readmission 29 . A study of 20 abdominal cancer patients reported that daily step count on postoperative day 7 inversely correlated with postoperative complication index 30 .…”

Telemedicine in patients with peripheral arterial disease: is it worth the effort?

“…The Fitbit is shown to be useful in other fields of medicine as well. Higher Fitbit step counts during inpatient recovery can predict lower readmission rates after metastatic peritoneal cancer surgery [16]. The Nike + FuelBand was used in one study [24] and has shown to be effective because of its ability to visualize the progress toward daily activity goals.…”

Continuous Digital Assessment for Weight Loss Surgery Patients

“…1 week), commonly using accelerometer-based measures of physical activity, during the 6-to 12-month postoperative period [2,3]. While there has been some interest in using commercial wearable devices to describe postoperative behavior, the currently available research has been limited in scope, typically bound to short observation windows and/or only focused on assessing daily physical activity behavior in the form of daily total steps [4][5][6][7][8][9]. Our current understanding of the changes in postoperative behavior and physiology may not reflect the true relationship between these changes and outcomes of interest such as successful weight loss, adverse event incidence, and resolution of obesity-related medical comorbidities.…”