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Use of a wrist-mounted device for continuous outpatient physiologic monitoring after transsphenoidal surgery: a pilot study



Patients who undergo transsphenoidal surgery can experience hormonal, electrolyte, and fluid disturbances in the postoperative period leading to outpatient readmissions for medical management. Our goal was to determine whether use of a wrist-mounted physiologic tracking device is feasible in this setting and whether changes or trends in these parameters after discharge can help predict aberrant physiology in these patients.


Wrist-mounted physiologic tracking devices that transmit data via Bluetooth to a mobile device were used to monitor patients. Preoperative baseline data and postoperative data were aggregated daily to compare within-patient and between-patient trends.


Of 11 patients enrolled in the study, 1 was readmitted for symptomatic hyponatremia. Device data completeness ranged from 78 to 93% with the exception of oxygen saturation (25% completeness). The patient with hyponatremia had a significantly lower baseline level of activity compared with other patients. Nonreadmitted patient activity variables (steps, calories, and distance) decreased by 48–52% after the operation (P < 0.001). The activity variables for the patient with hyponatremia were statistically unchanged after the operation; however, the patient did experience a significant decrease in heart rate compared with baseline.


Deployment of a wrist-based physiologic tracking device is feasible for surgical patients in elective clinical practice. Overall, the device was associated with good patient adherence and high patient satisfaction. Patient activity significantly decreased after surgery. A significant decrease in heart rate was detected in a patient with hyponatremia who required readmission, which reflects the known intravascular volume expansion in this state.

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Fig. 1

Reproduced with permission from Barrow Neurological Institute, Phoenix, Arizona

Fig. 2

Reproduced with permission from Barrow Neurological Institute, Phoenix, Arizona

Fig. 3

Reproduced with permission from Barrow Neurological Institute, Phoenix, Arizona



Beats per minute


Breaths per minute


Heart rate variation


Syndrome of inappropriate antidiuretic hormone secretion

SpO2 :

Oxygen saturation


  1. Kazaure HS, Roman SA, Sosa JA (2012) Association of postdischarge complications with reoperation and mortality in general surgery. Arch Surg 147(11):1000–1007.

    Article  PubMed  Google Scholar 

  2. Cook DJ, Thompson JE, Prinsen SK, Dearani JA, Deschamps C (2013) Functional recovery in the elderly after major surgery: assessment of mobility recovery using wireless technology. Ann Thorac Surg 96(3):1057–1061.

    Article  PubMed  Google Scholar 

  3. Lee JM, Kim Y, Welk GJ (2014) Validity of consumer-based physical activity monitors. Med Sci Sports Exerc 46(9):1840–1848.

    Article  PubMed  Google Scholar 

  4. Sasaki JE, Hickey A, Mavilia M, Tedesco J, John D, Kozey Keadle S, Freedson PS (2015) Validation of the Fitbit wireless activity tracker for prediction of energy expenditure. J Phys Act Health 12(2):149–154.

    Article  PubMed  Google Scholar 

  5. Dannecker KL, Sazonova NA, Melanson EL, Sazonov ES, Browning RC (2013) A comparison of energy expenditure estimation of several physical activity monitors. Med Sci Sports Exerc 45(11):2105–2112.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Diaz KM, Krupka DJ, Chang MJ, Peacock J, Ma Y, Goldsmith J, Schwartz JE, Davidson KW (2015) Fitbit(R): an accurate and reliable device for wireless physical activity tracking. Int J Cardiol 185:138–140.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Storm FA, Heller BW, Mazza C (2015) Step detection and activity recognition accuracy of seven physical activity monitors. PLoS ONE 10(3):e0118723.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Bohl MA, Ahmad S, White WL, Little AS (2018) Implementation of a postoperative outpatient care pathway for delayed hyponatremia following transsphenoidal surgery. Neurosurgery 82(1):110–117.

    Article  PubMed  Google Scholar 

  9. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, Initiative S (2008) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–349.

    Article  Google Scholar 

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The authors thank the staff of Neuroscience Publications at Barrow Neurological Institute for assistance with manuscript preparation.


We acknowledge the Lisa Family Foundation and Barrow Neurological Foundation for funding of this project. There was no contribution financially from the device manufacturer at any point during this study; however, the devices were provided free of charge for pilot study evaluation. All data analysis was performed independently from the device manufacturer.

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Correspondence to Andrew S. Little.

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Dr. Little is an investor in Kogent and has received stock options in Spiway. Dr. Nakaji has stock ownership in GT Medical Technologies and stock options in SpiWay. The other authors declare that they have no conflict of interest.

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Cole, T.S., Jahnke, H., Godzik, J. et al. Use of a wrist-mounted device for continuous outpatient physiologic monitoring after transsphenoidal surgery: a pilot study. Pituitary 22, 156–162 (2019).

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  • Hyponatremia
  • Outpatient
  • Physiologic monitoring
  • Pituitary adenoma
  • Transsphenoidal surgery