Association of Daily Step Count and Postoperative Complication among All of Us Research Participants

BACKGROUND:The association between preoperative wearable device step counts and surgical outcomes has not been examined using commercial devices linked to electronic health records (EHRs). This study measured the association between daily preoperative step counts and postoperative complications.STUDY DESIGN:Data were obtained using the All of Us (AOU) Research program, a nationwide initiative to collect EHR and health-related data from the population. Patients who underwent a surgical procedure included in the NSQIP-targeted procedures dataset were included. Patients who did not have available physical activity FitBit data were excluded. Primary outcome was the development of a postoperative complication. All analyses were performed in the AOU researcher workbench.RESULTS:Of 27,150 patients who underwent a surgical procedure, 475 participants with preoperative wearable data were included: 74.7% were female and 85.2% were White. The average age was 57.2 years. The overall rate of postoperative complications was 12.6%. Patients averaging less than 7,500 daily steps were at increased odds for developing a postoperative complication (odds ratio 1.83, 95% CI 1.01 to 3.31). After adjustment for age, sex, race, comorbid disease, BMI, and relative procedure risk, patients with a baseline average steps per day less than 7,500 were at increased odds for postoperative complication (adjusted odds ratio 2.06, 95% CI 1.05 to 4.06).CONCLUSIONS:This study found an increase in overall postoperative complication rate in patients recording lower average preoperative step counts. Patients with a baseline of less than 7,500 steps per day had increased odds of postoperative complications in this cohort. These data support the use of wearable devices for surgical risk stratification and suggest step count may measure preoperative fitness.