Outpatient surgery postoperative ambulation and emergency department utilization

Area of Science:

• Surgical Outcomes Research
• Wearable Technology in Healthcare
• Geriatric Surgery

Background:

• Ambulation is a critical indicator of wellness and recovery post-surgery.
• Traditional self-reported walking measurements are prone to bias.
• Wearable activity monitors offer objective data for assessing postoperative recovery.

Purpose of the Study:

• To evaluate postoperative ambulation using accelerometers in general surgery outpatients.
• To test the hypothesis that reduced postoperative ambulation predicts adverse outcomes.
• To identify risks associated with decreased mobility after outpatient abdominal surgery.

Main Methods:

• Retrospective review of 106 patients undergoing outpatient abdominal surgery (Nov 2016 - Jul 2019).
• Patients wore accelerometers preoperatively and postoperatively to measure daily steps.
• Outcomes included 30-day readmissions and Emergency Department (ED) utilization; ambulation was compared to preoperative baseline.

Main Results:

• Geriatric patients (≥65 years) were less likely to meet their preoperative baseline by postoperative day 7 (35% vs. 61%).
• Adult patients (<65 years) failing to meet baseline within one week had higher ED utilization (24% vs. 4%).
• Geriatric patients failing to meet baseline showed a trend toward increased ED visits (19% vs. 7%).

Conclusions:

• Adult patients (<65) not returning to their preoperative step count within one week are 6 times more likely to require ED visits.
• Postoperative ambulation levels can potentially predict ED utilization and recovery trajectory after outpatient surgery.
• Objective measurement of ambulation using wearable technology can inform recovery monitoring and risk stratification.