Highlights
- •A gap in knowledge exists in identifying hospital readmissions prior to their occurrence.
- •Measurement of daily walking represents a novel form of health telemetry.
- •A decrease of >50% daily ambulation over two days forecasts hospital readmission.
- •This finding represents a novel form of outpatient telemetry (tracking outpatient ambulation).
Abstract
Background
Surgical readmissions are clinically and financially problematic. Our purpose is to
determine if a decrease in postoperative ambulation (steps/day) is associated with
hospital readmission.
Methods
In this prospective cohort study, patients undergoing elective operations wore an
accelerometer activity tracker to measure steps/day for 28 consecutive postoperative
days. The primary outcome was hospital readmission. The change in steps/day over two
consecutive days prior to the day of the readmission were examined. Predetermined
thresholds for decreases of consecutive daily ambulation levels were used to calculate
sensitivity and specificity for the outcome of hospital readmission.
Results
215 patients (aged 63 ± 12 years) were included. Readmission occurred in 10% (n = 21).
For each of the first 28-postoperative days, the entire cohort had an average daily
step increase of 136 ± 146 steps/day (Spearman correlation rho = 0.990; p < 0.001).
A decrease in steps for two consecutive days of >50% from the prior day had a 79%
sensitivity and 90% specificity for hospital readmission.
Conclusions
A decrease of >50% daily ambulation (steps/day) over two consecutive post-discharge
days accurately forecasts hospital readmission. The implications of these findings
are that monitoring daily ambulation could serve as a form of outpatient telemetry
aiding to forecast post-surgical readmissions.
Keywords
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Article info
Publication history
Published online: August 09, 2021
Accepted:
August 7,
2021
Received in revised form:
August 5,
2021
Received:
May 25,
2021
Identification
Copyright
Published by Elsevier Inc.
