可穿戴活动追踪器在膀胱切除术患者中监测术后并发症的可行性。

Feasibility of wearable activity trackers in cystectomy patients to monitor for postoperative complications.

作者信息

Slade Austen D, Cardinal James R, Martin Christopher R, Presson Angela P, Allen Chelsea D, Lowrance William T, Dechet Christopher B, O'Neil Brock B

机构信息

Huntsman Cancer Institute, Department of Surgery, Division of Urology, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA.

出版信息

Curr Urol. 2021 Dec;15(4):209-213. doi: 10.1097/CU9.0000000000000030. Epub 2021 Jun 24.

Abstract

BACKGROUND

To determine the feasibility of using wearables in patients undergoing radical cystectomy to monitor postoperative heart rate and activity and attempt to correlate these factors to complications and readmissions.

MATERIALS AND METHODS

We conducted a prospective study of 20 patients undergoing radical cystectomy for bladder cancer between June 2017 and March 2018. Each patient was provided with a Garmin Vívofit heart rate (HR) activity tracker and instructed to wear it on their wrist for 30 days postoperatively. Heart rate, steps, and sleep data were collected during this time. Patients were called at 10-day intervals and surveyed for complications and device compliance. Univariable mixed effects logistic regression models were used to compare daily activity tracker measures with occurrence of an adverse event. Odds ratios, 95% confidence intervals, and -values were reported.

RESULTS

Median age was 65 (interquartile range 61-74) years. Patients had usable data for a median of 59.3% (interquartile range 25-71.7%) of the time. Five patients experienced a postoperative event (1 readmission for sepsis from urinary tract source, 1 inpatient rapid response called for tachycardic event, 3 unscheduled visits related to dehydration), where event data was recorded over a total of 17 days. Higher step count was associated with reduced odds of an adverse event (odds ratio 0.31, 95% confidence interval 0.10-0.98 per 1000 steps,  = 0.047).

CONCLUSIONS

Postoperative activity and heart rate monitoring in cystectomy patients is feasible though current wearables are not well suited for this task.

摘要

背景

确定在接受根治性膀胱切除术的患者中使用可穿戴设备监测术后心率和活动情况,并尝试将这些因素与并发症和再入院情况相关联的可行性。

材料与方法

我们对2017年6月至2018年3月期间因膀胱癌接受根治性膀胱切除术的20例患者进行了一项前瞻性研究。为每位患者提供了佳明Vívofit心率(HR)活动追踪器,并指示他们在术后30天佩戴在手腕上。在此期间收集心率、步数和睡眠数据。每隔10天给患者打电话,调查并发症和设备依从性情况。使用单变量混合效应逻辑回归模型比较每日活动追踪器测量值与不良事件的发生情况。报告比值比、95%置信区间和P值。

结果

中位年龄为65岁(四分位间距61 - 74岁)。患者可用数据的时间中位数为59.3%(四分位间距25 - 71.7%)。5例患者发生了术后事件(1例因泌尿道来源的败血症再次入院,1例因心动过速事件呼叫住院快速反应,3例因脱水进行了非计划就诊),事件数据总共记录了17天。步数增加与不良事件发生几率降低相关(每1000步比值比0.31,95%置信区间0.10 - 0.98,P = 0.047)。

结论

膀胱切除术后患者的活动和心率监测是可行的,尽管目前的可穿戴设备不太适合这项任务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa23/8772679/69adc12a94ec/curr-urol-15-209-g001.jpg

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