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Purpose <p>Electronic patient-reported outcomes (ePROs) are used postoperatively to detect complications through real-time symptom monitoring. This study examines whether alerts triggered through the “Recovery Tracker” (RT), an ePRO system, predict 30-day re-admission or re-operation after lumpectomy.</p> Methods <p>We retrospectively reviewed breast cancer patients who underwent lumpectomy at a single institution between August 2018 and May 2024. Patients who completed RT surveys on postoperative days 1–5 were included. Symptom alerts categorized as red (urgent) and yellow (less urgent) were analyzed using generalized additive and univariable logistic regression models.</p> Results <p>Among 8723 included patients, 2552 (29%) triggered at least one alert. Yellow alerts were more common than red across all days. Most red alerts were related to pain or vomiting; most yellow alerts were related to pain or wound redness. Overall, symptom severity and interference decreased over time. Triggering an alert was associated with increased risk of 30-day re-admission or re-operation (odds ratio [OR] 2.86, 95% confidence interval [CI] 1.64–5.03; p &lt; 0.001). However, absolute event rates were low (re-admission 0.3%, re-operation 0.2%), and the absolute risk increase associated with any alert was minimal (0.7%, 95% CI 0.2%–1.1%).</p> Conclusion <p>Although triggering at least one ePRO alert is associated with an increased relative risk for re-admission or re-operation, the absolute risk increase of re-admission and re-operation is very small. With enhanced follow-up by the clinical team among patients who trigger an alert, patients can be reassured that most symptoms will resolve on their own or can be treated with outpatient intervention.</p>

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Remote symptom monitoring with clinical alerts following lumpectomy: do alerts predict 30-day re-operation or re-admission rates?

  • 期刊论文

  • 发表日期：

    2026年2月14日

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  • Jennifer Wang,
  • Solange Bayard,
  • Melissa Assel,
  • Minji Kim,
  • Tracy-Ann Moo,
  • Andrew J. Vickers,
  • Sigrid V. Carlsson,
  • Babak Mehrara,
  • Monica Morrow,
  • Jonas A. Nelson,
  • Audree B. Tadros

摘要

Purpose

Electronic patient-reported outcomes (ePROs) are used postoperatively to detect complications through real-time symptom monitoring. This study examines whether alerts triggered through the “Recovery Tracker” (RT), an ePRO system, predict 30-day re-admission or re-operation after lumpectomy.

Methods

We retrospectively reviewed breast cancer patients who underwent lumpectomy at a single institution between August 2018 and May 2024. Patients who completed RT surveys on postoperative days 1–5 were included. Symptom alerts categorized as red (urgent) and yellow (less urgent) were analyzed using generalized additive and univariable logistic regression models.

Results

Among 8723 included patients, 2552 (29%) triggered at least one alert. Yellow alerts were more common than red across all days. Most red alerts were related to pain or vomiting; most yellow alerts were related to pain or wound redness. Overall, symptom severity and interference decreased over time. Triggering an alert was associated with increased risk of 30-day re-admission or re-operation (odds ratio [OR] 2.86, 95% confidence interval [CI] 1.64–5.03; p < 0.001). However, absolute event rates were low (re-admission 0.3%, re-operation 0.2%), and the absolute risk increase associated with any alert was minimal (0.7%, 95% CI 0.2%–1.1%).

Conclusion

Although triggering at least one ePRO alert is associated with an increased relative risk for re-admission or re-operation, the absolute risk increase of re-admission and re-operation is very small. With enhanced follow-up by the clinical team among patients who trigger an alert, patients can be reassured that most symptoms will resolve on their own or can be treated with outpatient intervention.