Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
J Surg Res. 2021 Jul;263:160-166. doi: 10.1016/j.jss.2021.01.030. Epub 2021 Mar 2.
Despite more than two million pediatric operations performed in the United States annually, normal postoperative recovery remains difficult to define. Wearable sensors that assess physical activity and vital signs in real time represent a tool to assess postoperative recovery. This study examined the use of a wearable, the FitBit Inspire HR, to describe recovery in children after appendectomy and to determine the sensitivity of wearable data to distinguish disease severity.
Children 3-18 y old undergoing appendectomy in a tertiary children's hospital were invited to participate. Participants wore the FitBit Inpire HR after surgery for 21 d. t-tests compared daily step counts, and piecewise linear regression models were fit to examine recovery trajectories for patients with simple and complicated appendicitis.
Thirty-two patients were enrolled, and 26 met eligibility criteria. Nine (35%) children had complicated appendicitis, and 14 (54%) were female; the mean age was 9.1 y (standard deviation: 2.9). Four hundred nineteen postoperative days were captured (range: 8-22 d; median: 16 d). Step counts increased after surgery; however, piecewise models showed that patients with simple appendicitis had a more rapid increase (P < 0.01) and reached a plateau (approximately 8000 steps/d) on postoperative day 9, whereas patients with complicated appendicitis did not reach a plateau and had lower step counts during the entire 21-postoperative day period (P < 0.01).
Recovery in children after surgery can be characterized using wearables, which can also distinguish recovery trajectories based on disease severity. Establishing such "normative" recovery patterns may lead to earlier detection of complications.
尽管美国每年进行超过两百万例儿科手术，但术后的正常恢复仍然难以定义。实时评估身体活动和生命体征的可穿戴传感器代表了评估术后恢复的一种工具。本研究使用可穿戴设备 Fitbit Inspire HR 来描述阑尾切除术后儿童的恢复情况，并确定可穿戴数据区分疾病严重程度的敏感性。
在一家三级儿童医院接受阑尾切除术的 3-18 岁儿童被邀请参加。参与者在手术后佩戴 Fitbit Inspire HR 21 天。t 检验比较了每日步数，分段线性回归模型用于分析单纯性和复杂性阑尾炎患者的恢复轨迹。
共纳入 32 名患者，其中 26 名符合入选标准。9 名（35%）儿童患有复杂性阑尾炎，14 名（54%）为女性；平均年龄为 9.1 岁（标准差：2.9）。共采集了 419 个术后日（范围：8-22 天；中位数：16 天）。术后步数增加；然而，分段模型显示单纯性阑尾炎患者的增加速度更快（P<0.01），并在术后第 9 天达到平台期（约 8000 步/天），而复杂性阑尾炎患者未达到平台期，并且在整个 21 天的术后期间步数较低（P<0.01）。
可以使用可穿戴设备来描述手术后儿童的恢复情况，并且还可以根据疾病严重程度区分恢复轨迹。建立这种“正常”恢复模式可能会更早地发现并发症。
