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

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

Fingerprint

Upper Extremity
Blood Vessels
Length of Stay
Logistic Models
Mortality
Elbow
Body Mass Index
Technology
Wounds and Injuries

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

Sensor-Based Upper-Extremity Frailty Assessment for the Vascular Surgery Risk Stratification. / Yanquez, Federico J.; Peterson, Anna; Weinkauf, Craig; Goshima, Kaoru R.; Zhou, Wei; Mohler, Jane; Ehsani, Hossein; Toosizadeh, Nima.

In: Journal of Surgical Research, 01.01.2019.

Research output: Contribution to journalArticle

Yanquez, Federico J. ; Peterson, Anna ; Weinkauf, Craig ; Goshima, Kaoru R. ; Zhou, Wei ; Mohler, Jane ; Ehsani, Hossein ; Toosizadeh, Nima. / Sensor-Based Upper-Extremity Frailty Assessment for the Vascular Surgery Risk Stratification. In: Journal of Surgical Research. 2019.
@article{a6f371b729034933bc8acd6e91d39938,
title = "Sensor-Based Upper-Extremity Frailty Assessment for the Vascular Surgery Risk Stratification",
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.",
keywords = "Mortality, Readmission, Surgery complication, Upper-limb function, Vascular surgery, Wearable sensors",
author = "Yanquez, {Federico J.} and Anna Peterson and Craig Weinkauf and Goshima, {Kaoru R.} and Wei Zhou and Jane Mohler and Hossein Ehsani and Nima Toosizadeh",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jss.2019.09.029",
language = "English (US)",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - Sensor-Based Upper-Extremity Frailty Assessment for the Vascular Surgery Risk Stratification

AU - Yanquez, Federico J.

AU - Peterson, Anna

AU - Weinkauf, Craig

AU - Goshima, Kaoru R.

AU - Zhou, Wei

AU - Mohler, Jane

AU - Ehsani, Hossein

AU - Toosizadeh, Nima

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

KW - Mortality

KW - Readmission

KW - Surgery complication

KW - Upper-limb function

KW - Vascular surgery

KW - Wearable sensors

UR - http://www.scopus.com/inward/record.url?scp=85073726525&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073726525&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2019.09.029

DO - 10.1016/j.jss.2019.09.029

M3 - Article

C2 - 31630882

AN - SCOPUS:85073726525

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

ER -