Postoperative Step Count Predicts Unplanned Readmission After Radical Esophagectomy: A Retrospective Cohort Study

Area of Science:

• Surgical Oncology
• Gerontology
• Rehabilitation Medicine

Background:

• Unplanned readmission post-esophagectomy increases costs and mortality.
• Postoperative physical activity may reduce readmission risk.
• Assessing physical activity's impact on readmission is crucial.

Purpose of the Study:

• Evaluate the association between postoperative step count and 90-day unplanned readmission.
• Identify an optimal step count threshold for predicting readmission risk.

Main Methods:

• Retrospective cohort study of 128 patients undergoing thoracic esophagectomy.
• Wearable activity trackers measured step counts in the final 7 days pre-discharge.
• Logistic regression and ROC curve analysis identified predictors and optimal cutoffs.

Main Results:

• 21.1% of patients experienced unplanned readmission.
• Higher daily step count (per 1000 steps) was associated with reduced readmission risk (OR 0.76).
• Optimal predictive cutoff was 2446 steps/day (AUC 0.691).

Conclusions:

• Lower pre-discharge step count independently predicts unplanned readmission.
• A target of ~2500 steps/day may guide postoperative rehabilitation strategies.
• Increasing physical activity could be a key intervention to lower readmission rates.