Comparing the ability of wearable devices and CPET to predict major complications following radical cystectomy
BAUS ePoster online library. Khetrapal P. 11/10/20; 304252; P12-11
Dr. Pramit Khetrapal
Dr. Pramit Khetrapal
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Comparing the ability of wearable devices and CPET to predict major complications following radical cystectomy

Khetrapal P1, Williams N2, Ambler G2, Sarpong R2, Mizon C2, Khan M3, Thurairaja R3, Tan M1, Feber A2, Dixon S4, Vasdev N5, Goodwin L4, McGrath J6, Charlesworth P7, Rowe E8, Koupparis A8, Kotwal S9, Ahmed I10, Hanchanale V11, Brew-Graves C2, Catto J4, Kelly J1
1University College London Hospital, United Kingdom, 2University College London, United Kingdom, 3Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, 4University of Sheffield, United Kingdom, 5Lister Hospital, Stevenage, United Kingdom, 6Royal Devonshire & Exeter NHS Trust, United Kingdom, 7Royal Berkshire Hospital, Reading, United Kingdom, 8North Bristol NHS Trust, United Kingdom, 9St James University Hospital, Leeds, United Kingdom, 10Queen Elizabeth University Hospital, Glasgow, United Kingdom, 11Royal Liverpool Hospital, United Kingdom

Introduction:
Wearable devices (WDs) represent an inexpensive method of collecting mobility data from patients. In many centres, cardiopulmonary exercise testing (CPET) is used to risk-stratify patients undergoing RC. In this study, we compare WD-derived mobility data with CPET variables used for risk-stratification in RC.
Materials & methods:
Patients recruited for a multi-centre RCT comparing open and robotic radical cystectomy (RC) were asked to wear a wrist-worn WD for seven days at baseline for 7 consecutive days prior to RC, and step-counts were logged. Patients also underwent CPET and were considered high-risk if: anaerobic threshold (AT) <11 or VE/VCO2 ≥33. Complications within 90 days were defined as Clavien-Dindo major (CD) ≥3 or minor (≤2).

Results:
10 of 57 (17.5%) patients had major complications in the post-operative 90 days, with patients having median daily step-counts of 8,626 (IQR: 6,561-12,358). Step-counts at baseline correlated significantly with both AT and VE/VCO2 (p=0.005 and p=0.002). Step-counts were significantly different in the different risk groups (p<0.001). A statistically significant (p<0.05) association between step-counts and major complications was identified. On ROC analysis, AUC (CI) for step-counts to predict CD≥3 complications was 0.719 (0.537-0.901). Logistic regression identified step-counts to be a statistically significant variable (p=0.04) in predicting major complications, but not CPET.

Conclusions:
Step-counts measured from WDs correlate strongly with CPET variables used for risk stratification and are significantly lower in the CPET high risk group. However, step-counts from WD are statistically significant predictor of major complications while CPET is not in this patient cohort.
Comparing the ability of wearable devices and CPET to predict major complications following radical cystectomy

Khetrapal P1, Williams N2, Ambler G2, Sarpong R2, Mizon C2, Khan M3, Thurairaja R3, Tan M1, Feber A2, Dixon S4, Vasdev N5, Goodwin L4, McGrath J6, Charlesworth P7, Rowe E8, Koupparis A8, Kotwal S9, Ahmed I10, Hanchanale V11, Brew-Graves C2, Catto J4, Kelly J1
1University College London Hospital, United Kingdom, 2University College London, United Kingdom, 3Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, 4University of Sheffield, United Kingdom, 5Lister Hospital, Stevenage, United Kingdom, 6Royal Devonshire & Exeter NHS Trust, United Kingdom, 7Royal Berkshire Hospital, Reading, United Kingdom, 8North Bristol NHS Trust, United Kingdom, 9St James University Hospital, Leeds, United Kingdom, 10Queen Elizabeth University Hospital, Glasgow, United Kingdom, 11Royal Liverpool Hospital, United Kingdom

Introduction:
Wearable devices (WDs) represent an inexpensive method of collecting mobility data from patients. In many centres, cardiopulmonary exercise testing (CPET) is used to risk-stratify patients undergoing RC. In this study, we compare WD-derived mobility data with CPET variables used for risk-stratification in RC.
Materials & methods:
Patients recruited for a multi-centre RCT comparing open and robotic radical cystectomy (RC) were asked to wear a wrist-worn WD for seven days at baseline for 7 consecutive days prior to RC, and step-counts were logged. Patients also underwent CPET and were considered high-risk if: anaerobic threshold (AT) <11 or VE/VCO2 ≥33. Complications within 90 days were defined as Clavien-Dindo major (CD) ≥3 or minor (≤2).

Results:
10 of 57 (17.5%) patients had major complications in the post-operative 90 days, with patients having median daily step-counts of 8,626 (IQR: 6,561-12,358). Step-counts at baseline correlated significantly with both AT and VE/VCO2 (p=0.005 and p=0.002). Step-counts were significantly different in the different risk groups (p<0.001). A statistically significant (p<0.05) association between step-counts and major complications was identified. On ROC analysis, AUC (CI) for step-counts to predict CD≥3 complications was 0.719 (0.537-0.901). Logistic regression identified step-counts to be a statistically significant variable (p=0.04) in predicting major complications, but not CPET.

Conclusions:
Step-counts measured from WDs correlate strongly with CPET variables used for risk stratification and are significantly lower in the CPET high risk group. However, step-counts from WD are statistically significant predictor of major complications while CPET is not in this patient cohort.
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