Synapse - Patient-reported symptoms after minimally invasive hysterectomy and association with postoperative complications

Patient-reported symptoms after minimally invasive hysterectomy and association with postoperative complications Journal Article

Authors:	Feinberg, J.; Zivanovic, O.; Hannon, M.; McCready, T.; Desai, P.; Kim, S. H.; Aviki, E. M.; Mueller, J. J.; Jewell, E. L.; Roche, K. L.; Gardner, G. J.; Chi, D. S.; Sonoda, Y.; Brown, C. L.; Abu-Rustum, N. R.; Cracchiolo, J. R.; Leitao, M. M. Jr; Broach, V.
Article Title:	Patient-reported symptoms after minimally invasive hysterectomy and association with postoperative complications
Abstract:	Objective: To describe patient-reported postoperative symptoms and to evaluate the use of digital symptom tracking and alerts to detect postoperative complications. Methods: We retrospectively reviewed patients who underwent a minimally invasive hysterectomy and enrolled in our Recovery Tracker program from 4/5/17–12/31/21. The Recovery Tracker is an at-home virtual tool used to track patient-reported postoperative symptoms for 10 days. Predefined thresholds for “red” and “yellow” alerts are based on symptom severity and timing. Data on patient demographics, surgery, and postoperative course were collected to evaluate the association of alerts with complications and compare outcomes of patients who did/did not enroll in the program. Results: Of 2362 eligible patients, 1694 (71.7%) enrolled in the Recovery Tracker program. Pain was the most severe symptom, followed by fatigue. Eighty-seven patients experienced 102 complications (5.1% complication rate) and 32 experienced 39 grade ≥ 2 complications (1.9% severe complication rate). Excluding complications that occurred prior to Recovery Tracker use, 1673 patients experienced 28 grade ≥ 2 complications. Of 345 patients (20.6%) who triggered a red alert, 13 (3.8%) had a grade ≥ 2 complication. Of 1328 patients (79.4%) with no red alerts, 15 (1.13%) had a grade ≥ 2 complication. Relative risk of a grade ≥ 2 complication if a red alert was triggered was 3.25 (95% CI: 1.6–6.9, P = .002). Rate of severe complications was significantly higher among patients who did not use the tool (3.3% vs 1.9%; P = .04). Conclusions: The Recovery Tracker tool may assist in early identification of postoperative symptoms after minimally invasive hysterectomy. © 2023
Keywords:	adult; controlled study; retrospective studies; major clinical study; fatigue; outcome assessment; hysterectomy; lymph node dissection; laparoscopy; pain; nausea; vomiting; retrospective study; risk factor; chill; dyspnea; postoperative complication; postoperative complications; minimally invasive surgery; cross-sectional study; patient reported outcome measures; radical hysterectomy; swelling; demographics; patient-reported outcome; contusion; minimally invasive surgical procedures; humans; human; male; female; article; likert scale; patient-reported symptoms; digital health; postoperative recovery; recovery tracker; minimally invasive hysterectomy
Journal Title:	Gynecologic Oncology
Volume:	175
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2023-08-01
Start Page:	163
End Page:	168
Language:	English
DOI:	10.1016/j.ygyno.2023.06.011
PUBMED:	37390597
PROVIDER:	scopus
PMCID:	PMC10939506
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85163465157&doi=10.1016%2fj.ygyno.2023.06.011&partnerID=40&md5=9a53c17be1a4b566bd29bc97fdaabffb
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Vance Broach -- Source: Scopus