1442. Use of a wrist-mounted device for continuous outpatient physiologic monitoring after transsphenoidal surgery: a pilot study

Authors: Tyler Scott Cole, MD; Jakub Godzik, MD; Clinton Morgan, MD; Andrew Little, MD; Peter Nakaji, MD (Phoenix, AZ)

Introduction: Patients who undergo transsphenoidal surgery may experience electrolyte and fluid disturbances in the postoperative period. Our goal was to determine whether use of a wrist-mounted device capable of tracking a comprehensive array of physiologic parameters is feasible in this setting and whether changes or trends in these parameters after discharge can help predict aberrant physiology in these patients. Methods: Wrist-mounted physiologic tracking devices that transmit data via Bluetooth to a mobile device were used to monitor patients. Preoperative baseline data and postoperative data were recorded and aggregated daily to compare within-patient and between-patient trends. Results: Of seven enrolled patients, one patient was readmitted to the hospital for symptomatic hyponatremia. Device adherence during the preoperative period ranged from 88.9% to 100%. Postoperative data completeness ranged from 78% to 93% with the exception of oxygen saturation (25% completeness). The patient with hyponatremia had a significantly lower baseline level of activity before and after the operation compared with other patients. Among patients who were not readmitted, activity variables decreased by 48% to 52% after the operation ( P < .001). Postoperative activity variables for the patient with hyponatremia were stable compared with preoperatively; however, the patient experienced a significant decrease in heart rate (26% decrease; P = .04). When all postoperative trends in physiologic variables were analyzed via hierarchical clustering, the patient with hyponatremia clustered separately. This suggests a possible physiologic signature unique for patients with hyponatremia. Conclusion: Wrist-based physiologic tracking devices are feasible for surgical patients. Patient activity significantly decreased after surgery. A significant decrease in heart rate was detected in a patient with hyponatremia, reflecting the known intravascular volume expansion in this state. This hyponatremic patient also had a lower level of baseline activity compared with the other patients. Wrist-mounted physiologic trackers represent a new modality to monitor postoperative outpatient recovery.