Physical and Cognitive Function Assessment to Predict Postoperative Outcomes of Abdominal Surgery

Martha Ruiz, Miguel Peña, Audrey Cohen, Hossein Ehsani, Bellal Joseph, Mindy Fain, Jane Mohler, Nima Toosizadeh

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)495-505
Number of pages11
JournalJournal of Surgical Research
Volume267
DOIs
StatePublished - Nov 2021

Keywords

  • Cognition
  • Frailty
  • Post-discharge outcomes
  • Surgical complications
  • Upper-extremity motion

ASJC Scopus subject areas

  • Surgery

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