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Kavallieros K, Karakozis L, Hayward R, Giannas E, Selvaggi L, Kontovounisios C. Wearable Devices in Colorectal Surgery: A Scoping Review. Cancers (Basel) 2024; 16:2303. [PMID: 39001367 PMCID: PMC11240327 DOI: 10.3390/cancers16132303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 07/16/2024] Open
Abstract
Wearable devices are increasingly utilised to monitor patients perioperatively, allowing for continuous data collection and early complication detection. There is considerable variability in the types and usage settings of wearables, particularly within colorectal surgery. To address this, a scoping review was conducted to investigate current utilisation of wearable devices in colorectal surgery. A systematic search across MEDLINE and Embase was conducted following PRISMA Scoping Review guidelines. Results were synthesised narratively, categorised by perioperative phase (preoperative; postoperative; combination), and supplemented with descriptive statistics and tables. Out of 1525 studies initially identified, 20 were included, reporting data on 10 different wearable devices. Use of wearable devices varied across settings with those used preoperatively tending to focus on baseline physical status or prehabilitation, while postoperative use centred around monitoring and identification of complications. Wearable devices can enhance perioperative monitoring, enable proactive interventions, and promote personalised care for improved patient outcomes in colorectal surgery.
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Affiliation(s)
- Konstantinos Kavallieros
- Department of Surgery and Cancer, Imperial College London, London SW7 2BX, UK; (K.K.); (L.K.); (R.H.); (E.G.); (C.K.)
- Department of General Surgery, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Lampros Karakozis
- Department of Surgery and Cancer, Imperial College London, London SW7 2BX, UK; (K.K.); (L.K.); (R.H.); (E.G.); (C.K.)
- Department of General Surgery, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Romilly Hayward
- Department of Surgery and Cancer, Imperial College London, London SW7 2BX, UK; (K.K.); (L.K.); (R.H.); (E.G.); (C.K.)
- Department of General Surgery, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Emmanuel Giannas
- Department of Surgery and Cancer, Imperial College London, London SW7 2BX, UK; (K.K.); (L.K.); (R.H.); (E.G.); (C.K.)
- Department of General Surgery, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Lucio Selvaggi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Christos Kontovounisios
- Department of Surgery and Cancer, Imperial College London, London SW7 2BX, UK; (K.K.); (L.K.); (R.H.); (E.G.); (C.K.)
- Department of General Surgery, Chelsea and Westminster Hospital, London SW10 9NH, UK
- Department of Surgery, The Royal Marsden Hospital, London SW3 6JJ, UK
- 2nd Surgical Department, Evangelismos General Hospital, 10676 Athens, Greece
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Naumann DN, Bhangu A, Brooks A, Martin M, Cotton BA, Khan M, Midwinter MJ, Pearce L, Bowley DM, Holcomb JB, Griffiths EA. Novel Textbook Outcomes following emergency laparotomy: Delphi exercise. BJS Open 2024; 8:zrad128. [PMID: 38284399 PMCID: PMC10823418 DOI: 10.1093/bjsopen/zrad128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/16/2023] [Accepted: 11/03/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Textbook outcomes are composite outcome measures that reflect the ideal overall experience for patients. There are many of these in the elective surgery literature but no textbook outcomes have been proposed for patients following emergency laparotomy. The aim was to achieve international consensus amongst experts and patients for the best Textbook Outcomes for non-trauma and trauma emergency laparotomy. METHODS A modified Delphi exercise was undertaken with three planned rounds to achieve consensus regarding the best Textbook Outcomes based on the category, number and importance (Likert scale of 1-5) of individual outcome measures. There were separate questions for non-trauma and trauma. A patient engagement exercise was undertaken after round 2 to inform the final round. RESULTS A total of 337 participants from 53 countries participated in all three rounds of the exercise. The final Textbook Outcomes were divided into 'early' and 'longer-term'. For non-trauma patients the proposed early Textbook Outcome was 'Discharged from hospital without serious postoperative complications (Clavien-Dindo ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation or death). For trauma patients it was 'Discharged from hospital without unexpected transfusion after haemostasis, and no serious postoperative complications (adapted Clavien-Dindo for trauma ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation on or death)'. The longer-term Textbook Outcome for both non-trauma and trauma was 'Achieved the early Textbook Outcome, and restoration of baseline quality of life at 1 year'. CONCLUSION Early and longer-term Textbook Outcomes have been agreed by an international consensus of experts for non-trauma and trauma emergency laparotomy. These now require clinical validation with patient data.
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Affiliation(s)
- David N Naumann
- Department of Trauma and Emergency General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Aneel Bhangu
- Department of Trauma and Emergency General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- NIHR Global Health Unit on Global Surgery, Institute of Translational Medicine, University of Birmingham, Birmingham, UK
| | - Adam Brooks
- East Midlands Major Trauma Centre, Queen's Medical Centre, Nottingham, UK
| | - Matthew Martin
- Division of Trauma and Acute Care Surgery, Department of Surgery, Los Angeles County & USC Medical Center, Los Angeles, California, USA
| | - Bryan A Cotton
- The Center for Translational Injury Research, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Mansoor Khan
- Department of General Surgery, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Mark J Midwinter
- School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Lyndsay Pearce
- Department of General Surgery, Salford Royal NHS Foundation Trust, Salford, UK
| | - Douglas M Bowley
- Department of Trauma and Emergency General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - John B Holcomb
- Division of Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ewen A Griffiths
- Department of Trauma and Emergency General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Sharabi A, Abutbul E, Grossbard E, Martsiano Y, Berman A, Kassif-Lerner R, Hakim H, Liber P, Zoubi A, Barkai G, Segal G. Six-Lead Electrocardiography Enables Identification of Rhythm and Conduction Anomalies of Patients in the Telemedicine-Based, Hospital-at-Home Setting: A Prospective Validation Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:8464. [PMID: 37896557 PMCID: PMC10611340 DOI: 10.3390/s23208464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/01/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The hospital-at-home (HAH) model is a viable alternative for conventional in-hospital stays worldwide. Serum electrolyte abnormalities are common in acute patients, especially in those with many comorbidities. Pathologic changes in cardiac electrophysiology pose a potential risk during HAH stays. Periodical electrocardiogram (ECG) tracing is therefore advised, but few studies have evaluated the accuracy and efficiency of compact, self-activated ECG devices in HAH settings. This study aimed to evaluate the reliability of such a device in comparison with a standard 12-lead ECG. METHODS We prospectively recruited consecutive patients admitted to the Sheba Beyond Virtual Hospital, in the HAH department, during a 3-month duration. Each patient underwent a 12-lead ECG recording using the legacy device and a consecutive recording by a compact six-lead device. Baseline patient characteristics during hospitalization were collected. The level of agreement between devices was measured by Cohen's kappa coefficient for inter-rater reliability (Ϗ). RESULTS Fifty patients were included in the study (median age 80 years, IQR 14). In total, 26 (52%) had electrolyte disturbances. Abnormal D-dimer values were observed in 33 (66%) patients, and 12 (24%) patients had elevated troponin values. We found a level of 94.5% raw agreement between devices with regards to nine of the options included in the automatic read-out of the legacy device. The calculated Ϗ was 0.72, classified as a substantial consensus. The rate of raw consensus regarding the ECG intervals' measurement (PR, RR, and QT) was 78.5%, and the calculated Ϗ was 0.42, corresponding to a moderate level of agreement. CONCLUSION This is the first report to our knowledge regarding the feasibility of using a compact, six-lead ECG device in the setting of an HAH to be safe and bearing satisfying agreement level with a legacy, 12-lead ECG device, enabling quick, accessible arrythmia detection in this setting. Our findings bear a promise to the future development of telemedicine-based hospital-at-home methodology.
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Affiliation(s)
- Adam Sharabi
- Beyond Virtual Hospital, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
- Faculty of Medicine, University of Nicosia, 2408 Nicosia, Cyprus
| | - Eli Abutbul
- Beyond Virtual Hospital, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
- Faculty of Medicine, University of Nicosia, 2408 Nicosia, Cyprus
| | - Eitan Grossbard
- Beyond Virtual Hospital, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
- Faculty of Medicine, University of Nicosia, 2408 Nicosia, Cyprus
| | - Yonatan Martsiano
- Beyond Virtual Hospital, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
- Faculty of Medicine, University of Nicosia, 2408 Nicosia, Cyprus
| | - Aya Berman
- Dan Petah-Tikvah District at Clalit Health Services, Petah Tikva 4922297, Israel
| | - Reut Kassif-Lerner
- Department of Pediatric Intensive Care, The Edmond and Lily Safra Children’s Hospital Sheba Medical Center, Affiliated to the Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
| | - Hila Hakim
- Beyond Virtual Hospital, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
| | - Pninit Liber
- Beyond Virtual Hospital, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
| | - Anram Zoubi
- Beyond Virtual Hospital, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
| | - Galia Barkai
- Beyond Virtual Hospital, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
| | - Gad Segal
- Beyond Virtual Hospital, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv 5265601, Israel
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