title: Postoperative Gastrointestinal Telemetry with an Acoustic Biosensor Predicts Ileus vs. Uneventful GI Recovery.
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.
  
  
  METHODS
  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 (P = 0.03). AGIS predicted POI onset with a sensitivity, specificity, and NPV of 63, 72, and 81%, respectively.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA.|Departments of Medicine and Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Kaneshiro
authors.affiliation: Henry Samueli School of Engineering and Applied Science at UCLA, Los Angeles, CA, USA.
authors.forename: William
authors.initials: W
authors.lastname: Kaiser
authors.affiliation: Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Pourmorady
authors.affiliation: Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Phillip
authors.initials: P
authors.lastname: Fleshner
authors.affiliation: Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Russell
authors.affiliation: Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Zaghiyan
authors.affiliation: Departments of Medicine and Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Lin
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA.
authors.forename: Bibiana
authors.initials: B
authors.lastname: Martinez
authors.affiliation: Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA.
authors.forename: Anish
authors.initials: A
authors.lastname: Patel
authors.affiliation: Departments of Medicine and Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Nguyen
authors.affiliation: Henry Samueli School of Engineering and Applied Science at UCLA, Los Angeles, CA, USA.
authors.forename: Digvijay
authors.initials: D
authors.lastname: Singh
authors.affiliation: Henry Samueli School of Engineering and Applied Science at UCLA, Los Angeles, CA, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Zegarski
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Reid
authors.affiliation: Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA.
authors.forename: Francis
authors.initials: F
authors.lastname: Dailey
authors.affiliation: Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Xu
authors.affiliation: Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Robbins
authors.affiliation: Departments of Medicine and Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. brennan.spiegel@cshs.org.|Departments of Medicine and Surgery, West Los Angeles VA Medical Center, Los Angeles, CA, USA. brennan.spiegel@cshs.org.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA. brennan.spiegel@cshs.org.|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.
authors.forename: Brennan
authors.initials: B
authors.lastname: Spiegel
mesh_terms: D000162:Acoustics; D015374:Biosensing Techniques; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D045823:Ileus / Q000209:etiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013686:Telemetry / Q000295:instrumentation* / Q000379:methods*
keywords: Biosensor; Health technology; Postoperative ileus