Using wireless technology may speed patients' postoperative recovery following heart surgery and improve post-discharge outcomes, according to a study in the September 2013 issue of The Annals of Thoracic Surgery.
"This type of technology will transform the assessment of surgical and medical recovery," said lead study author David J. Cook, MD, from the Mayo Clinic in Rochester, MN. "When an older patient is hospitalized—whether it's for surgery or another medical condition—that patient's ability to regain strength and mobility is a primary determinant of whether the patient can go home and be independent."
Using an off-the-shelf fitness monitor, Dr. Cook and colleagues monitored the total number of steps taken each day by patients following elective heart surgery (coronary artery bypass grafting, valve repair or replacement, or both). Study patients were older than age 50, lived at home, were ambulatory prior to surgery, and were expected to be hospitalized for 5-7 days following surgery.
Fitness monitors were placed on ankles of each patient following discharge from the intensive care unit. Day of placement was identified as recovery day 1.
For analysis, patients were grouped by length of hospital stay (LOS) (short, intermediate, or long) and discharge location [home, home with health care (HHC) support, or skilled nursing facility (SNF)].
On recovery day 2, the researchers found significant differences in mobility among patients who were later discharged home independently compared with those discharged home with HHC support or to a SNF. The median number of steps measured on recovery day 2 for the home group was 675 vs. 108 steps for the HHC and SNF groups. This gap was also evident on recovery days 3 and 4.
The researchers also found that patients with short and intermediate lengths of stay walked more on recovery days 1 and 2 compared with patients with a long LOS. By the end of recovery day 2, patients with a short LOS reached a median of 818 steps vs. 514 and 223 steps in the intermediate and long LOS groups, respectively.
Dr. Cook noted that while the results were not unexpected, they are unique because they represent the first demonstration that remote monitoring of mobility is effective in assessing hospital surgical recovery, and such data have implications for resource utilization and outcomes.