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The following is a summary of “Using Consumer Wearable Devices to Profile Postoperative Complications After Pediatric Appendectomy,” published in the December 2023 issue of Surgery by Pitt et al.
Understanding postoperative recovery in pediatric patients following hospital discharge is complex, especially for parents relying on subjective assessments to gauge recovery and anticipate complications. This study explores the potential of consumer-grade wearable devices, such as Fitbit, to provide objective and real-time recovery data, enabling remote monitoring of postoperative patients beyond their initial hospital stay. Specifically, the investigation aims to compare the recovery patterns, measured through daily step counts using Fitbit devices, between patients experiencing complications and those without complications after undergoing appendectomy for complicated appendicitis. Children aged 3-17 undergoing laparoscopic appendectomy were enrolled, wearing Fitbit devices for 21 days post-operation. Minimum wear-time criteria were considered for data analysis. Postoperative complications were identified via chart review, and step count trajectories were compared between patients with and without complications.
Furthermore, median daily step counts before and after complication occurrences were assessed to account for variations in complication onset days. The study comprised 86 patients with complicated appendicitis, among whom 14 developed postoperative complications, delineated into abscesses (n = 7, 64%), surgical site infections (n = 2, 18%), and other complications such as small bowel obstruction and Clostridioides difficile infection (n = 2, 18%). Notably, patients exhibited deviations from the anticipated recovery trajectory around four days before the manifestation of complications, with the mean day of complication presentation at postoperative day 8. Comparison of recovery trajectories highlighted slower postoperative step count increments in patients facing surgical complications, with distinct recovery patterns unique to each complication type. Adjusted for the day of complication presentation, step counts were consistently lower before the identification of complications and showed subsequent increases post-treatment, mirroring the expected recovery trajectory. These findings underscore the potential of leveraging wearable devices to monitor pediatric postoperative recovery in outpatient settings, offering objective data for earlier identification of complications after hospital discharge.
Source: sciencedirect.com/science/article/abs/pii/S0022480423005620
