Background

This research aimed to determine whether patterns of temporal changes in activity levels can indicate postoperative complications following hepatectomy.

Methods

Between December 2016 and December 2019, 147 patients wore an accelerometer to measure their physical activity levels after hepatectomy until postoperative day 7. Patterns of changes in activity levels were categorized as follows: upward slope type (n = 88), wherein activity levels gradually increased; bell curve type (n = 13), wherein activity levels initially increased but subsequently decreased; and flat type (n = 46), wherein there was no apparent increase in activity levels. Patient characteristics and postoperative complications were compared for each group.

Results

Postoperative complications occurred in 4.5% of patients in the upward slope group, in 76.9% in the bell curve group, and in 65.2% in the flat group (p < 0.001). Surgical site infections (SSI), refractory pleural effusion, and ascites were more common in the bell curve group, while pneumonia was only observed in the flat group.

Conclusion

SSI, pleural effusion, and ascites should be considered when previously increasing activity levels decline during the postoperative period. In addition, there is a high risk of SSI and pneumonia when activity levels do not increase at all after surgery.

中文翻译：

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使用加速度计测量身体活动水平的时间变化对预测和早期发现肝切除术后并发症的有用性

背景

本研究旨在确定活动水平的时间变化模式是否可以指示肝切除术后的术后并发症。

方法

2016 年 12 月至 2019 年 12 月，147 名患者佩戴加速度计测量肝切除术后至术后第 7 天的体力活动水平。活动水平变化模式分类如下：向上倾斜型（n = 88），其中活动水平逐渐增加; 钟形曲线类型（n = 13），其中活动水平最初增加但随后减少；和扁平型（n = 46），其中活动水平没有明显增加。比较各组的患者特征和术后并发症。

结果

上坡组 4.5%、钟形曲线组 76.9%、平坦组 65.2% 的患者出现术后并发症（p < 0.001）。手术部位感染（SSI）、难治性胸腔积液和腹水在钟形曲线组中更常见，而肺炎仅在平坦组中观察到。

结论

当先前增加的活动水平在术后期间下降时，应考虑 SSI、胸腔积液和腹水。此外，当手术后活动水平完全不增加时，SSI 和肺炎的风险很高。