Physical and Cognitive Function Assessment to Predict Postoperative Outcomes of Abdominal Surgery
| Autor: | Nima Toosizadeh, Miguel Peña, Martha Ruiz, Bellal Joseph, Jane Mohler, Audrey Cohen, Hossein Ehsani, Mindy J. Fain |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Longitudinal study Aftercare Logistic regression Article Upper Extremity Cognition Predictive Value of Tests Abdomen Covariate Humans Medicine Longitudinal Studies Effects of sleep deprivation on cognitive performance Geriatric Assessment Aged business.industry Patient Discharge Test (assessment) Treatment Outcome Physical therapy Surgery Observational study business Abdominal surgery |
| Zdroj: | J Surg Res |
| ISSN: | 0022-4804 |
| DOI: | 10.1016/j.jss.2021.05.018 |
| Popis: | Background Current evaluation methods to assess physical and cognitive function are limited and often not feasible in emergency settings. The upper-extremity function (UEF) test to assess physical and cognitive performance using wearable sensors. The purpose of this study was to examine the (1) relationship between preoperative UEF scores with in-hospital outcomes; and (2) association between postoperative UEF scores with 30-d adverse outcomes among adults undergoing emergent abdominal surgery. Methods We performed an observational, longitudinal study among adults older than 40 y who presented with intra-abdominal symptoms. The UEF tests included a 20-sec rapid repetitive elbow flexion (physical function), and a 60-sec repetitive elbow flexion at a self-selected pace while counting backwards by threes (cognitive function), administered within 24-h of admission and within 24-h prior to discharge. Multiple logistic regression models assessed the association between UEF and outcomes. Each model consisted of the in-hospital or 30-d post-discharge outcome as the dependent variable, preoperative UEF physical and cognitive scores as hypothesis covariates, and age and sex as adjuster covariates. Results Using UEF physical and cognitive scores to predict in-hospital outcomes, an area under curve (AUC) of 0.76 was achieved, which was 17% more sensitive when compared to age independently. For 30-d outcomes, the AUC increased to 0.89 when UEF physical and cognitive scores were included in the model with age and sex. Discussion Sensor-based measures of physical and cognitive function enhance outcome prediction providing an objective practicable tool for risk stratification in emergency surgery settings among aging adults presenting with intra-abdominal symptoms. |
| Databáze: | OpenAIRE |
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