Abstract: TH-PO276
Trends in Physical Activity before Hospitalization: A Prospective Observational Study in Patients on Hemodialysis Using Wearable Activity Trackers
Session Information
- Hemodialysis and Frequent Dialysis - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Han, Maggie, Renal Research Institute, New York, New York, United States
- Wang, Yuedong, University of California Santa Barbara, Santa Barbara, California, United States
- Tao, Xia, Renal Research Institute, New York, New York, United States
- Preciado, Priscila, Renal Research Institute, New York, New York, United States
- Tisdale, Lela, Renal Research Institute, New York, New York, United States
- Thwin, Ohnmar, Renal Research Institute, New York, New York, United States
- Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background
Data collected by wearable devices may lead to timely intervention prior to a marked clinical decline. We aimed to determine if physical activity levels, measured with a wearable activity tracker, changed prior to hospitalization in hemodialysis (HD) patients.
Methods
HD patients from 4 New York City clinics were enrolled starting in June 2018 and followed for up to 1 year. Ambulatory patients ≥18 years, on maintenance HD, and owning a mobile device were included. Each patient was provided with and taught how to use a wearable activity tracker (Fitbit Charge 2®), and they were instructed to wear the device continuously. Hospitalization events were recorded and separated into two categories: unexpected hospitalizations and expected hospitalizations (vascular access procedure, scheduled surgeries). Rehospitalizations were not included in the analysis. We fit cubic spline models to daily averages of total steps 30 days prior to expected and unexpected hospitalizations, respectively, and compute p-values for testing the hypothesis of a constant function prior to hospitalizations using the bootstrap method.
Results
42 patients (54±13 years, 57% Black, 71% male, 33% diabetic) were included in this analysis. 59 hospitalizations were recorded, with 51 unexpected and 8 expected hospitalizations. Prior to unexpected hospitalizations, the number of steps per day declined significantly (p=0.030) (Figure 1a). In contrast, steps per day increased significantly in expected hospitalizations (p=0.039) (Figure 1b).
Conclusion
Physical activity levels decline prior to unexpected hospitalizations. A marked decrease in steps per day may be an early indication of subsequent clinical decline. Additional research is warranted to further investigate the relationship between wearables data, clinical events, and intervention strategies.