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J Gastrointest Surg. 2016 Jan;20(1):132-9; discussion 139. doi: 10.1007/s11605-015-2956-3. Epub 2015 Sep 25.

Postoperative Gastrointestinal Telemetry with an Acoustic Biosensor Predicts Ileus vs. Uneventful GI Recovery.

Author information

1
Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
2
Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA.
3
Departments of Medicine and Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
4
Henry Samueli School of Engineering and Applied Science at UCLA, Los Angeles, CA, USA.
5
Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA.
6
Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. brennan.spiegel@cshs.org.
7
Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA. brennan.spiegel@cshs.org.
8
Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA. brennan.spiegel@cshs.org.
9
Department of Medicine, Divisions of Health Services Research and Gastroenterology, Cedars-Sinai Medical Center, 116 N. Robertson Blvd, 4th Floor, Los Angeles, CA, 90048, USA. brennan.spiegel@cshs.org.

Abstract

BACKGROUND:

Postoperative ileus (POI) can worsen outcomes, increase cost, and prolong hospitalization. We previously found that a disposable, non-invasive acoustic gastrointestinal surveillance (AGIS) biosensor distinguishes healthy controls from patients recovering from abdominal surgery. Here, we tested whether AGIS can prospectively predict which patients will develop POI in a multicenter study.

STUDY DESIGN:

AGIS is a disposable device embedded with a microphone that adheres to the abdominal wall and connects to a computer that measures acoustic intestinal rate (IR), defined as motility events/minute. We applied AGIS for 60 min before and continuously after abdominal surgery. Clinicians blinded to AGIS recordings clinically separated patients into those with vs. without POI. We used receiver operating characteristic curve analysis to calculate sensitivity, specificity, and negative predictive value (NPV) of AGIS to predict POI.

RESULTS:

There were 28 subjects; nine developed POI. Median IR was 3.01/min and 4.46/min between POI and non-POI groups, respectively (Pā€‰=ā€‰0.03). AGIS predicted POI onset with a sensitivity, specificity, and NPV of 63, 72, and 81%, respectively.

CONCLUSION:

Non-invasive, abdominal, acoustic monitoring prospectively predicts POI. Surgeons may use AGIS to rule out POI with over 80% certainty; this offers added confidence to advance feeding earlier in those for whom it is safe.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT02065583.

KEYWORDS:

Biosensor; Health technology; Postoperative ileus

PMID:
26408329
DOI:
10.1007/s11605-015-2956-3
[Indexed for MEDLINE]

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