Abstract
Background
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.
Materials and methods
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.
Results
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).
Conclusions
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.
Keywords
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References
- Epidemiology of pediatric surgical admissions in US children: data from the HCUP kids inpatient database.J Neurosurg Anesthesiol. 2012; 24: 391-395
- Development and psychometric testing of a quality of recovery score after general anesthesia and surgery in adults.Anesth Analg. 1999; 88: 83-90
- A critical appraisal of the quality of quality-of-life measurements.JAMA. 1994; 272: 619-626
- Health status, quality of life, and the individual.JAMA. 1994; 272: 630-631
- Measuring health: a guide to rating scales and questionnaires.Oxford University Press, New York1987: 380-383
- Postoperative pain and quality of recovery.Curr Opin Anaesthesiol. 2004; 17: 455-460
- Quality of life measurement: bibliographic study of patient assessed health outcome measures.BMJ. 2002; 324: 1417
- Parents' perceptions and use of analgesics at home after children's day surgery.Paediatr Anaesth. 2003; 13: 132-140
- Pediatric pain after ambulatory surgery: where's the medication?.Pediatrics. 2009; 124: e588-e595
- Context and significance of emergency department visits and readmissions after pediatric appendectomy.J Pediatr Surg. 2011; 46: 1918-1922
- Wearable technology-A pilot study to define "normal" postoperative recovery trajectories.J Surg Res. 2019; 244: 368-373
- Functional recovery in the elderly after major surgery: assessment of mobility recovery using wireless technology.Ann Thorac Surg. 2013; 96: 1057-1061
- Wireless monitoring program of patient-centered outcomes and recovery before and after major abdominal cancer surgery.JAMA Surg. 2017; 152: 852-859
- Using accelerometers to characterize recovery after surgery in children.J Pediatr Surg. 2018; 53: 1600-1605
- Systematic review of the validity and reliability of consumer-wearable activity trackers.Int J Behav Nutr Phys Act. 2015; 12: 159
- Physical activity assessment in adolescents with limb salvage.J Pediatr. 2012; 161: 1138-1141
- Physical activity evaluation in children with congenital heart disease.Heart. 2017; 103: 1408-1412
- Accuracy of wrist-worn activity monitors during common daily physical activities and types of structured exercise: evaluation study.JMIR Mhealth Uhealth. 2018; 6: e10338
- Accuracy of a wrist-worn heart rate sensing device during elective pediatric surgical procedures.Children (Basel). 2018; 5: 38
- Accelerometer-determined steps per day in US children and youth.Med Sci Sports Exerc. 2010; 42: 2244-2250
- Use of a fitness tracker to promote physical activity in children with acute lymphoblastic leukemia.Pediatr Blood Cancer. 2016; 63: 684-689
- The use of a Fitbit device for assessing physical activity and sedentary behavior in preschoolers.J Pediatr. 2018; 199: 35-40
- Feasibility and effectiveness of using wearable activity trackers in youth: a systematic review.JMIR Mhealth Uhealth. 2016; 4: e129
- Using novel technology within a school-based setting to increase physical activity: a pilot study in school-age children from a low-income.Urban Community Biomed Res Int. 2017; 2017: 4271483
Article info
Publication history
Published online: March 02, 2021
Accepted:
January 18,
2021
Received in revised form:
January 12,
2021
Received:
November 20,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
