Perioperative Mobility Assessment of Patients Undergoing Endoscopic Endonasal Surgeries for Sellar Lesions Using Digital Phenotyping

Introduction: Current methods to assess quality of life and recovery after endoscopic endonasal surgery for sellar lesions are limited and often biased by subjective patient-reported assessments, while objective, in-situ assessments are lacking. Smartphone-based digital phenotyping has been increasingly studied across a variety of pathologies, utilizing built in technologies to measure behavioral patterns pertaining to sleep, physical mobility, social interactions, and cognitive functioning, among others. Here, we report our initial experience with smartphone-based digital phenotyping in patients who underwent endoscopic endonasal resection of sellar lesions at our institution.

Methods: Patients with sellar lesions were enrolled during preoperative clinic visits under an institutional board-approved protocol and installed the Beiwe application, which passively collected GPS data in the time leading up to surgery and in the post-operative period. Data were collected 60 days pre- and post-surgery and were comprised of measurements of daily distance traveled, maximal distance traveled from home, number of separate places visited outside of home, and overall time spent at home. Mean values for these metrics in the pre-operative period (14 days leading up to surgery), immediate postoperative period (14 days right after surgery, and delayed postoperative period (14–28 days after surgery) were subsequently compared. Data were plotted via Spline regression lines.

Results: Between July 2016–February 2020 (pre-COVID) and September 2022–July 2023 (post-COVID), 30 patients were enrolled who met study inclusion criteria. Pathologies comprised of 21 pituitary adenomas, 4 pituitary cysts/Rathke’s cleft cyst, 2 craniopharyngiomas, 1 adenohypophysitis, 1 meningioma, and 1 arachnoid cyst. Patients spent more time at home in the immediate (16.9 hours) and delayed (18.4) postoperative period compared to preoperative baseline (15.6 hours).

Fig. 1

Mobility-wise, patients demonstrated a similar level of daily kilometers traveled in the immediate postoperative period vs. preoperative baseline (46.6 km vs. 46.3 km, respectively), which increased in the delayed postoperative period (50.0 km).

Fig. 2

Patients frequented fewer separate places outside home and traveled shorter maximal distances from home in the immediate postoperative period vs. preoperative baseline (3.4 vs. 2.8 places; 5.6 vs. 4.6 km). However, these measures trended back towards baseline values in the delayed postoperative period (3.4 vs. 3.2 places; 5.6 km vs. 5.0 km).

Fig. 3

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Conclusion: This study demonstrates initial efficacy of digital phenotyping for a cohort of patients undergoing endoscopic endonasal surgery for sellar lesions, based on passively collected smartphone GPS data during the peri-operative period. This is part of a larger, ongoing study enrolling surgical patients as well as nonoperative controls for comparison. With the establishment of an in-situ tool to monitor recovery following endoscopic endonasal surgery for sellar lesions, such peri-operative mobility metrics may be further utilized to predict postoperative outcomes following surgery such as postoperative CSF leak, infection, dysnatremia, and hospital length of stay.

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Artikel online veröffentlicht:
05. Februar 2024