Sensor-Based Upper-Extremity Frailty Assessment for the Vascular Surgery Risk Stratification

Area of Science:

• Gerontology
• Biomedical Engineering
• Vascular Surgery

Background:

• Current methods for assessing vascular surgery patient outcomes are often subjective or unsuitable for nonambulatory individuals.
• Physical frailty assessment is crucial for predicting surgical outcomes.
• Wearable motion sensor technology offers a potential solution for objective frailty assessment.

Purpose of the Study:

• To evaluate the association between vascular surgery outcomes and a validated upper-extremity function (UEF) method.
• To determine if UEF, incorporating wearable motion sensors, can objectively assess physical frailty in vascular surgery patients.
• To explore the predictive value of UEF-based frailty assessment for surgical outcomes.

Main Methods:

• Recruited patients aged 50 years or older undergoing vascular surgery.
• Administered a 20-second UEF test involving rapid elbow flexion, quantified by wearable motion sensors.
• Assessed surgical outcomes including hospital stay, discharge disposition, 30-day mortality, complications, readmission, and reintervention.

Main Results:

• Significant associations were found between frailty status and adverse surgical outcomes.
• Frail participants experienced hospital stays three times longer than nonfrail individuals (P=0.03).
• Frail patients had a higher risk of mortality (P<0.01) and adverse discharge disposition (P=0.01).

Conclusions:

• The UEF method provides an objective and simple approach to assess physical frailty in vascular surgery patients.
• This validated UEF method can predict adverse events, particularly in nonambulatory patients.
• UEF assessment represents a novel tool for improving patient management and outcomes in vascular surgery.