Determining the Reliable Measurement Period for Preoperative Baseline Values With Telemonitoring Before Major Abdominal Surgery: Pilot Cohort Study

BackgroundPreoperative telemonitoring of vital signs, physical activity, and well-being might be able to optimize prehabilitation of the patient’s physical and mental condition prior to surgery, support setting alarms during in-hospital monitoring, and allow personalization o...

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Main Authors: Marjolein E Haveman, Rianne van Melzen, Mostafa El Moumni, Richte C L Schuurmann, Hermie J Hermens, Monique Tabak, Jean-Paul P M de Vries
Format: Article
Language:English
Published: JMIR Publications 2022-11-01
Series:JMIR Perioperative Medicine
Online Access:https://periop.jmir.org/2022/1/e40815
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author Marjolein E Haveman
Rianne van Melzen
Mostafa El Moumni
Richte C L Schuurmann
Hermie J Hermens
Monique Tabak
Jean-Paul P M de Vries
author_facet Marjolein E Haveman
Rianne van Melzen
Mostafa El Moumni
Richte C L Schuurmann
Hermie J Hermens
Monique Tabak
Jean-Paul P M de Vries
author_sort Marjolein E Haveman
collection DOAJ
description BackgroundPreoperative telemonitoring of vital signs, physical activity, and well-being might be able to optimize prehabilitation of the patient’s physical and mental condition prior to surgery, support setting alarms during in-hospital monitoring, and allow personalization of the postoperative recovery process. ObjectiveThe primary 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). The secondary aim was to describe the perioperative course of these measurements at home. MethodsIn 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. Intraclass correlation coefficients (ICCs) were used to evaluate the reliability of mean values on 2 specific preoperative days (the first day of telemonitoring and the day before hospital admission) and randomly selected preoperative periods compared to individual reference values. Mean values of HR, step count, and PROMs per day were visualized in a boxplot from 14 days before hospital admission until 30 days after surgery. ResultsA total of 16 patients were included in the data analyses. The 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 over the continuous period of time from 0.68 to 0.99 for HR and daily step counts. A lower bound of the 95% CI of at least 0.75 was determined after 3 days of measurements. The ICCs of randomly selected PROM measurements were 0.89-0.94. Visualization of mean values per day mainly showed variable preoperative daily step counts (median 2409, IQR 1735-4661 steps/day) and lower postoperative daily step counts (median 884, IQR 474-1605 steps/day). In addition, pain was visually reduced until 30 days after surgery at home. ConclusionsIn this prospective pilot study, for 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 3 consecutive days and PROMs during any preoperative day. No clear conclusions were drawn from the description of the perioperative course by showing mean values of HR, daily step count, and PROM values over time in the home situation.
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spelling doaj.art-c7ef53bc5e784c568a954a1db2e2ed202024-02-03T10:40:45ZengJMIR PublicationsJMIR Perioperative Medicine2561-91282022-11-0151e4081510.2196/40815Determining the Reliable Measurement Period for Preoperative Baseline Values With Telemonitoring Before Major Abdominal Surgery: Pilot Cohort StudyMarjolein E Havemanhttps://orcid.org/0000-0002-6030-3172Rianne van Melzenhttps://orcid.org/0000-0003-0919-6532Mostafa El Moumnihttps://orcid.org/0000-0001-6186-7757Richte C L Schuurmannhttps://orcid.org/0000-0001-7253-3939Hermie J Hermenshttps://orcid.org/0000-0002-3065-3876Monique Tabakhttps://orcid.org/0000-0001-5082-1112Jean-Paul P M de Vrieshttps://orcid.org/0000-0002-2669-320X BackgroundPreoperative telemonitoring of vital signs, physical activity, and well-being might be able to optimize prehabilitation of the patient’s physical and mental condition prior to surgery, support setting alarms during in-hospital monitoring, and allow personalization of the postoperative recovery process. ObjectiveThe primary 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). The secondary aim was to describe the perioperative course of these measurements at home. MethodsIn 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. Intraclass correlation coefficients (ICCs) were used to evaluate the reliability of mean values on 2 specific preoperative days (the first day of telemonitoring and the day before hospital admission) and randomly selected preoperative periods compared to individual reference values. Mean values of HR, step count, and PROMs per day were visualized in a boxplot from 14 days before hospital admission until 30 days after surgery. ResultsA total of 16 patients were included in the data analyses. The 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 over the continuous period of time from 0.68 to 0.99 for HR and daily step counts. A lower bound of the 95% CI of at least 0.75 was determined after 3 days of measurements. The ICCs of randomly selected PROM measurements were 0.89-0.94. Visualization of mean values per day mainly showed variable preoperative daily step counts (median 2409, IQR 1735-4661 steps/day) and lower postoperative daily step counts (median 884, IQR 474-1605 steps/day). In addition, pain was visually reduced until 30 days after surgery at home. ConclusionsIn this prospective pilot study, for 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 3 consecutive days and PROMs during any preoperative day. No clear conclusions were drawn from the description of the perioperative course by showing mean values of HR, daily step count, and PROM values over time in the home situation.https://periop.jmir.org/2022/1/e40815
spellingShingle Marjolein E Haveman
Rianne van Melzen
Mostafa El Moumni
Richte C L Schuurmann
Hermie J Hermens
Monique Tabak
Jean-Paul P M de Vries
Determining the Reliable Measurement Period for Preoperative Baseline Values With Telemonitoring Before Major Abdominal Surgery: Pilot Cohort Study
JMIR Perioperative Medicine
title Determining the Reliable Measurement Period for Preoperative Baseline Values With Telemonitoring Before Major Abdominal Surgery: Pilot Cohort Study
title_full Determining the Reliable Measurement Period for Preoperative Baseline Values With Telemonitoring Before Major Abdominal Surgery: Pilot Cohort Study
title_fullStr Determining the Reliable Measurement Period for Preoperative Baseline Values With Telemonitoring Before Major Abdominal Surgery: Pilot Cohort Study
title_full_unstemmed Determining the Reliable Measurement Period for Preoperative Baseline Values With Telemonitoring Before Major Abdominal Surgery: Pilot Cohort Study
title_short Determining the Reliable Measurement Period for Preoperative Baseline Values With Telemonitoring Before Major Abdominal Surgery: Pilot Cohort Study
title_sort determining the reliable measurement period for preoperative baseline values with telemonitoring before major abdominal surgery pilot cohort study
url https://periop.jmir.org/2022/1/e40815
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