Sensor-Based Upper-Extremity Frailty Assessment for the Vascular Surgery Risk Stratification

Federico J. Yanquez, Anna Peterson, Craig Weinkauf, Kaoru R. Goshima, Wei Zhou, Jane Mohler, Hossein Ehsani, Nima Toosizadeh

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Available methods for determining outcomes in vascular surgery patients are often subjective or not applicable in nonambulatory patients. The purpose of the present study was to assess the association between vascular surgery outcomes and a previously validated upper-extremity function (UEF) method, which incorporates wearable motion sensors for the physical frailty assessment. Materials and methods: Patients (≥50 y old) undergoing vascular surgery were recruited. Participants performed the 20-s UEF test, which involved rapid elbow flexion. This technology quantifies physical frailty features including slowness, weakness, exhaustion, and flexibility, which allows grouping individuals into nonfrail, prefrail, and frail categories. Surgical outcomes included length of hospital stay, discharged disposition, and 30-d mortality, complications, readmission, and reintervention(s). Associations between outcomes and frailty were assessed using nominal logistic regression models, adjusted for age, gender, body mass index, and wound classification. Results: Thirty-seven participants were recruited: eight nonfrail (age = 62.0 ± 10.6); 22 prefrail (age = 65.6 ± 11.6); and seven frail (age = 68.0 ± 8.0). Significant associations were observed between frailty and length of hospital stay (three times longer among frail participants, P = 0.03), mortality after surgery (two incidents among frail participants, P < 0.01), and adverse discharge disposition (all nonfrail patients were discharged home, whereas only 43% of frail patients discharged home, P = 0.01). Conclusions: This is the first study to validate the utility of UEF among patients undergoing any vascular surgery. Findings suggest that UEF may provide an objective and simple approach for assessing frailty to predict adverse events after vascular surgery, especially for nonambulatory patients.

Original languageEnglish (US)
JournalJournal of Surgical Research
DOIs
StateAccepted/In press - Jan 1 2019

Keywords

  • Mortality
  • Readmission
  • Surgery complication
  • Upper-limb function
  • Vascular surgery
  • Wearable sensors

ASJC Scopus subject areas

  • Surgery

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    Yanquez, F. J., Peterson, A., Weinkauf, C., Goshima, K. R., Zhou, W., Mohler, J., Ehsani, H., & Toosizadeh, N. (Accepted/In press). Sensor-Based Upper-Extremity Frailty Assessment for the Vascular Surgery Risk Stratification. Journal of Surgical Research. https://doi.org/10.1016/j.jss.2019.09.029