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可穿戴技术——定义“正常”术后恢复轨迹的初步研究。

Wearable Technology-A Pilot Study to Define "Normal" Postoperative Recovery Trajectories.

机构信息

Department of Surgery, University of Colorado, Aurora, Colorado.

Department of Surgery, University of Colorado, Aurora, Colorado.

出版信息

J Surg Res. 2019 Dec;244:368-373. doi: 10.1016/j.jss.2019.06.057. Epub 2019 Jul 16.

Abstract

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.

摘要

背景

新兴的可穿戴技术有可能量化术前和术后患者的活动。本研究的目的是描述常见手术 1 个月后的术后恢复轨迹。

材料与方法

纳入的患者计划接受常见的择期手术。在术前至少佩戴可穿戴活动设备 3 天,术后 28 天。术后每天的步数与术前基线步数进行比较,恢复轨迹以患者基线值的百分比报告。根据入院类型和手术类型比较组间的恢复轨迹。

结果

共纳入 210 例患者,其中 143 例(68%)完成了随访。患者术前平均每天走 5342 步,术后第一天的步数明显减少,包括腹股沟疝修补术患者(基线步数的 22%,P<0.001)。术后 4 周,微创腹部(基线的 88%,P=0.035)、开腹(基线的 64%,P=0.002)和胸部(基线的 32%,P=0.002)手术患者的每日步数仍未恢复到基线。所有患者组在术后第一周内表现出快速的步数恢复,随后恢复速度较慢。恢复轨迹因入院类型和手术类型而异。

结论

可穿戴活动监测器为量化与术前活动水平相比术后每日活动恢复轨迹提供了有用的技术,内部有效性通过手术类型和入院类型的广泛分类来区分恢复轨迹分组。活动恢复是一种以患者为中心的结果,可用于咨询以及通过干预来提高手术后的活动水平。

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