JMIR Publications

ABSTRACT

Background:

Preoperative telemonitoring of vital signs, physical activity and wellbeing might be able to assist in clinical decision making, optimize prehabilitation of the patient’s physical and/or mental condition prior to surgery, support setting alarms during in-hospital monitoring, and allow personalization of the postoperative recovery process.

Objective:

The aim of this study was to evaluate when and how long patients awaiting major abdominal surgery should be monitored to get reliable preoperative individual baseline values of heart rate (HR), daily step count, and patient-reported outcome measures (PROMs).

Methods:

In this observational single-center cohort study, patients used a wearable sensor during waking hours, and reported PROMs (pain, anxiety, fatigue, nausea) on a tablet twice a day. Intra-class correlation coefficients (ICC) were used to evaluate the reliability of mean values on two specific preoperative days (the first day of telemonitoring and the day before hospital admission) and on randomly selected preoperative periods compared to individual reference values.

Results:

Sixteen patients were included in data analyses. ICCs of mean values on the first day of telemonitoring were 0.91 for HR, 0.71 for steps, and at least 0.86 for PROMs. The day before hospital admission showed reliability coefficients of 0.76 for HR, 0.71 for steps, and 0.92-0.99 for PROMs. ICC values of randomly selected measurement periods increased with increasing the continuous period of time from 0.68 to 0.99 for HR and daily step counts. A lower bound of the 95% confidence intervals of at least 0.75 was determined after three days of measurements. ICCs of randomly selected PROMs measurements were 0.89-0.94.

Conclusions:

In this prospective pilot study, patients awaiting major abdominal surgery, baseline values for HR and daily step count could be measured reliably by a wearable sensor worn for at least three consecutive days, and PROMs during any preoperative day.