Wireless monitoring before and after cancer surgery
Is it feasible to wirelessly monitor patient-centered outcomes and recovery before and after major abdominal cancer surgery? Researchers at the City of Hope Hospital in Duarte, California, performed a proof-of-concept pilot study to answer this question.
The study included 20 patients with a median age of 55 years, who were scheduled to undergo curative resection for hepatobiliary and gastrointestinal cancers. The patients wore wristband pedometers and completed online patient-reported outcome surveys (symptoms and quality of life) at three points in time: three to seven days before surgery, during hospitalization, and up to two weeks after discharge. Primary outcomes measures included adherence to wearing the pedometer and adherence to completing the surveys (MD Anderson Symptom Inventory and EuroQol 5-dimensional descriptive system).
88 percent of patients adhered to the pedometer before surgery, 83 percent after discharge. The survey adherence was 65 and 75 percent, respectively. The median number of daily steps at day 7 was 1,689, which corresponds to 19 percent of daily steps at baseline. Patients reported an only mild post-discharge overall symptom severity (2.3 of 10) and only little interference of symptoms with daily activities (3.5 of 10). After surgery, the patients reported moderate pain (4.4 of 10), fatigue (4.7 of 10), and appetite loss (4.0 of 10). Quality-of-life scores were lowest at discharge (66.6 of 100) but showed a marked improvement after two weeks (73.9 of 100). Patient-reported outcomes returned to baseline at two weeks, but the number of daily steps was only one-third of preoperative baseline.
Wireless monitoring of patient-centered outcomes can be carried out in the surgical oncology setting, conclude the authors. Monitoring patient-centered outcomes, both before and after surgery, could facilitate the identification of high-risk populations to better support postoperative functional and symptom recovery.