Ratcliffe A M, Zhai B, Guan Y, Jackson D G, Sneyd J R
Department of Anaesthesia, University Hospitals Plymouth NHS Trust, Plymouth, UK.
Open Lab, School of Computing, Newcastle University, Newcastle upon Tyne, UK.
Anaesthesia. 2021 Jun;76(6):785-797. doi: 10.1111/anae.15267. Epub 2020 Oct 5.
This pilot and feasibility study evaluated wrist-worn accelerometers to measure recovery from day-case surgery in comparison with daily quality of recovery-15 scores. The protocol was designed with extensive patient and public involvement and engagement, and delivered by a research network of anaesthesia trainees. Forty-eight patients recruited through pre-operative assessment clinics wore wrist accelerometers for 7 days before (pre-operative) and immediately after elective surgery (early postoperative), and again at 3 months (late postoperative). Validated activity and quality of recovery questionnaires were administered. Raw accelerometry data were archived and analysed using open source software. The mean (SD) number of valid days of accelerometer wear per participant in the pre-operative, early and late postoperative periods were 5.4 (1.7), 6.6 (1.1) and 6.6 (1.0) days, respectively. On the day after surgery, Euclidian norm minus one (a summary measure of raw accelerations), step count, light physical activity and moderate/vigorous physical activity decreased to 57%, 47%, 59% and 35% of baseline values, respectively. Activity increased progressively on a daily basis but had not returned to baseline values by 7 days. Patient questionnaires suggested subjective recovery by postoperative day 3 to 4; however, accelerometry data showed that activity levels had not returned to baseline at this point. All activity measures had returned to baseline by 3 months. Wrist-worn accelerometery is acceptable to patients and feasible as a surrogate measure for monitoring postoperative recovery from day-case surgery. Our results suggest that patients may overestimate their rate of recovery from day-case surgery, which has important implications for future research.
这项试点和可行性研究评估了腕部佩戴的加速度计，以测量日间手术的恢复情况，并与每日恢复质量-15评分进行比较。该方案在患者和公众的广泛参与下设计，并由麻醉实习医生研究网络实施。通过术前评估诊所招募的48名患者在择期手术前（术前）、术后即刻（术后早期）佩戴腕部加速度计7天，术后3个月（术后晚期）再次佩戴。发放了经过验证的活动和恢复质量问卷。原始加速度计数据存档后使用开源软件进行分析。每位参与者在术前、术后早期和晚期佩戴加速度计的有效天数的平均值（标准差）分别为5.4（1.7）天、6.6（1.1）天和6.6（1.0）天。术后第一天，欧几里得范数减一（原始加速度的汇总指标）、步数、轻度体力活动和中度/剧烈体力活动分别降至基线值的57%、47%、59%和35%。活动量每天逐渐增加，但到第7天时仍未恢复到基线值。患者问卷显示术后第3至4天主观恢复；然而，加速度计数据显示此时活动水平尚未恢复到基线。所有活动指标在3个月时均恢复到基线。腕部佩戴加速度计患者可接受，作为监测日间手术后恢复情况的替代指标可行。我们的结果表明，患者可能高估了他们从日间手术中的恢复速度，这对未来的研究具有重要意义。
