Pitt J Benjamin, Carter Michela, Zeineddin Suhail, Bai Iris, Hua Rui, Kwon Soyang, Ghomrawi Hassan, Abdullah Fizan
Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Shirley Ryan Ability Lab, Chicago, IL, USA.
J Pediatr Surg. 2025 Feb;60(2):162016. doi: 10.1016/j.jpedsurg.2024.162016. Epub 2024 Oct 18.
Postoperative recovery of children is difficult to gauge by parents after hospital discharge. Consumer wearable devices (CWD) generate valid and near real-time pulse rate data, integer pulse rate variability (PRVi), that can serve as digital biomarkers for the onset of complications during post-discharge recovery. This study sought to explore whether pediatric patients with surgical complications after appendectomy exhibited a CWD-derived PRVi trajectory that differs from the normative PRVi recovery trajectory.
In this retrospective analysis, children aged 3-17 undergoing appendectomy for complicated appendicitis was invited to participate. Participants wore a Fitbit device for 21 days postoperatively. PRVi was calculated as the variance, defined as the sum of the squared differences of each value from the mean, of the heart rate in beats per minute measured over 5 consecutive minutes. The mean daily PRVi was calculated for patients recovering with and without complications.
Ninety-eight patients were enrolled in the study; 60 (61 %) were ages 3-11, 54 (55 %) were female, and 57 (58 %) were Caucasian. Eleven (11 %) developed surgical complications. Those with complications experienced a slower increase in the mean PRVi over the 21-day period.
In this prospective observational study, it was demonstrated that PRVi derived from CWD data can be used as an objective digital biomarker to profile surgical complications. This finding provides clinicians with an additional tool for monitoring children during the postoperative period, enhancing their ability to proactively detect and address complications.
IV.
出院后，家长很难判断孩子术后的恢复情况。消费级可穿戴设备（CWD）能生成有效且近乎实时的脉搏率数据，即整数脉搏率变异性（PRVi），可作为出院后恢复期间并发症发生的数字生物标志物。本研究旨在探讨阑尾切除术后出现手术并发症的儿科患者是否表现出与正常PRVi恢复轨迹不同的CWD衍生PRVi轨迹。
在这项回顾性分析中，邀请了3至17岁因复杂性阑尾炎接受阑尾切除术的儿童参与。参与者术后佩戴Fitbit设备21天。PRVi计算为方差，方差定义为连续5分钟测量的每分钟心跳次数的心率中每个值与平均值的平方差之和。计算有并发症和无并发症恢复患者的每日平均PRVi。
98名患者纳入研究；60名（61%）年龄在3至11岁，54名（55%）为女性，57名（58%）为白种人。11名（11%）出现手术并发症。有并发症的患者在21天内平均PRVi的增加较慢。
在这项前瞻性观察研究中，证明了从CWD数据得出的PRVi可作为一种客观的数字生物标志物来描述手术并发症。这一发现为临床医生在术后监测儿童提供了额外的工具，增强了他们主动检测和处理并发症的能力。
IV级。
