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Anupama Singh, MD

Pronouns

She/Her/Hers

Job Title

Research Fellow

Academic Rank

Department

Surgery

Authors

Anupama Singh, MD

Principal Investigator

Michael T. Jaklitsch, MD

Research Category: Lung Research

Tags

Pre-Operative Home Exercise Challenge in Older Thoracic Patients

Scientific Abstract

Older patients undergoing thoracic surgery have higher rates of frailty, with longer hospital lengths of stay and complicated discharge planning. Studies have demonstrated the association between increased daily step counts and decreased mortality. However, the impact of pre-operative steps on postoperative outcomes is unknown. We initiated a pilot study administering fit bits to 30 patients in clinic from 9/2021 to 7/2022 who were undergoing any thoracic surgery. The objective was to assess the feasibility of in-home step tracking. Primary aims were tracking of steps for at least 5 days, return of equipment/daily log and ease of data extraction. Results are as follows: 6 patients didn’t participate, 24 patients completed at least 5 days, and all equipment was returned. Data extraction was imperfect, and technology malfunctioning occurred for 2 patients (fit bit login deleted & another fit bit tracked less than 100 steps daily despite patient’s robust activity level). Overall, this was a successful pilot study that demonstrated that in-home step tracking is feasible. We will continue to recruit patients and gather additional data. We will encourage completing the paper log for comparison to fit bit recording and will call patients to encourage ambulation.

Lay Abstract

Older patients having chest surgery have longer hospital stays. Some studies showed that an increased number of steps daily is associated with decreased risk of death, but we don’t know the relationship between activity level before surgery and how well patients do after surgery. We started a study giving fit bits to 30 patients in clinic from 9/2021 to 7/2022 who were having chest surgery. We wanted to see if patients tracked steps for at least 5 days, if equipment was returned, and if it was easy to get the information on the fit bit app afterward. Results were: 6 patients didn’t participate, 24 patients tracked steps for at least 5 days, and all equipment was returned. Getting the data from the iPad was sometimes hard because the login for one fit bit was deleted and another fit bit tracked less than 100 steps daily even though the patient was very active. Overall, this was a successful study that showed that tracking steps at home is do-able. We will continue to get more patients for the study. We will encourage patients to complete the paper log as a backup option, and we will call patients to remind them to participate.

Clinical Implications

Administering fit bits to patients in thoracic surgery clinics is a feasible measure that can be implemented nationwide. With additional data, this can potentially be a point of intervention to help improve postoperative outcomes in this frail population.