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An estimated 4 million children undergo surgical procedures in hospitals across the U.S. each year. Although postoperative complications, such as infections, can pose significant health risks to kids, timely detection following hospital discharge can prove challenging.

A new study published in Science Advances — and led by researchers at Northwestern University, Shirley Ryan AbilityLab and University of Alabama at Birmingham — is the first to use consumer wearables to quickly and precisely predict postoperative complications in children and shows potential for facilitating faster treatment and care.

“Today, consumer wearables are ubiquitous, with many of us relying on them to count our steps, measure our sleep and more,” said senior author Arun Jayaraman, professor of physical medicine and rehabilitation, medical social sciences and physical therapy and human movement sciences at Northwestern University Feinberg School of Medicine and a scientist at Shirley Ryan AbilityLab. “Our study is the first to take this widely available technology and train the algorithm using new metrics that are more sensitive in detecting complications. Our results suggest great promise for better patient outcomes and have broad implications for pediatric health monitoring across various care settings.”

How the study worked

As part of the study, commercially available Fitbit devices were given to 103 children for 21 days immediately after appendectomy — the most common surgery in children, which results in complications up to 38% of the time. Rather than just using the metrics automatically captured by the Fitbit to identify signs of complications (e.g., low activity, high heart rate, etc.), Shirley Ryan AbilityLab scientists trained the algorithm using new metrics related to the circadian rhythms of a child’s activity and heart rate patterns. 

In the process, they found such metrics were more sensitive to picking up complications than the traditional metrics. In fact, in analyzing the data, scientists were able to retrospectively predict postoperative complications up to three days before formal diagnosis with 91% sensitivity and 74% specificity. 

“Historically, we have been reliant upon subjective reporting from children — who often have greater difficulty articulating their symptoms — and their caregivers following hospital discharge. As a result, complications are not always caught right away,” said study author Dr. Fizan Abdullah, who at the time of the study was an attending physician of pediatric surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and a professor at Feinberg. “By using widely available wearables, coupled with this novel algorithm, we have an opportunity to change the paradigm of postoperative monitoring and care — and improve outcomes for kids in the process.”

What’s next?

This research is part of a four-year National Institutes of Health-funded project. As a next step, scientists plan to transition this approach into a real-time (vs. retrospective) system that analyzes data automatically and sends alerts to children’s clinical teams. 

“This study reinforces wearables’ potential to complement clinical care for better patient recoveries,” said Hassan M.K. Ghomrawi, vice chair of research and innovation in the department of orthopaedic surgery at University of Alabama at Birmingham. “Our team is eager to enter the next phase of research exploration.”

June 30, 2025 — A new ESC Clinical Consensus Statement published in the European Heart Journal discusses the key role of vaccination in preventing cardiovascular events following various viral and bacterial infections.¹

“We have known for many years that influenza can increase the risk of major adverse cardiovascular events such as heart attacks and can exacerbate heart failure,” said Professor Thomas F. Lüscher, ESC President and senior author of the ESC Clinical Consensus Statement. “More recently, evidence suggests that other respiratory infections are also associated with increased cardiovascular morbidity and mortality. The new publication describes how vaccinations not only prevent infections but also reduce the risk of cardiovascular events, particularly in susceptible individuals.” 

The ESC Clinical Consensus Statement describes data on the risk of cardiovascular complications following infections such as pneumococcal pneumonia, influenza, SARS-CoV-2 and respiratory syncytial virus, among others, and describes the inflammatory mechanisms that may be responsible. Evidence is then summarised for the beneficial effects of vaccines in reducing cardiovascular events following various viral and bacterial infections, particularly in at-risk patient groups. Clinical practice guidelines from the ESC and from the American College of Cardiology (ACC)/American Heart Association (AHA) are presented, which advocate for vaccination against influenza and other widespread infections in patients with chronic coronary syndromes (including coronary artery disease) and in those with heart failure. 

Serious adverse reactions to vaccinations are very rare. The consensus statement also discusses the risks of cardiovascular adverse events after vaccination, such as myocarditis, and describes appropriate management strategies. Then follows advice on which vaccines should be given to patients with cardiovascular diseases and how often. Vaccination of pregnant women and other vulnerable patient groups, such as those with congenital heart disease and heart transplantation, is considered.  

Professor Lüscher concluded: “Prevention is crucial for reducing the considerable burden of cardiovascular disease. The totality of the evidence indicates that vaccinations should become a foundational pillar of preventive strategies alongside other established measures.”

References and notes: 
¹Heidecker B, Libby P, Vassiliou VS, et al. Vaccination as a new form of cardiovascular prevention: an ESC Clinical Consensus Statement. Eur Heart J. 2025. doi: 10.1093/eurheartj/ehaf384.  https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehaf384

The ESC Clinical Consensus Statement was created with the European Association of Preventive Cardiology (EAPC), the Association for Acute CardioVascular Care (ACVC) and the Heart Failure Association (HFA) of the ESC. 

Devices like Fitbits can more quickly and accurately predict postoperative complications like infection

An estimated 4 million children undergo surgical procedures in hospitals across the U.S. each year. Although postoperative complications, such as infections, can pose significant health risks to kids, timely detection following hospital discharge can prove challenging.

A new study published in Science Advances — and led by scientists at Northwestern University, Shirley Ryan AbilityLab and University of Alabama at Birmingham — is the first to use consumer wearables to quickly and precisely predict postoperative complications in children and shows potential for facilitating faster treatment and care.

“Today, consumer wearables are ubiquitous, with many of us relying on them to count our steps, measure our sleep and more,” said senior author Arun Jayaraman, PhD, PT, professor of Physical Medicine and Rehabilitation, of Physical Therapy and Human Movement Sciences, and of Medical Social Sciences, who is also a scientist at Shirley Ryan AbilityLab. “Our study is the first to take this widely available technology and train the algorithm using new metrics that are more sensitive in detecting complications. Our results suggest great promise for better patient outcomes and have broad implications for pediatric health monitoring across various care settings.”

How the study worked

As part of the study, commercially available Fitbit devices were given to 103 children for 21 days immediately after appendectomy — the most common surgery in children, which results in complications up to 38 percent of the time. Rather than just using the metrics automatically captured by the Fitbit to identify signs of complications (e.g., low activity, high heart rate, etc.), Shirley Ryan AbilityLab scientists trained the algorithm using new metrics related to the circadian rhythms of a child’s activity and heart rate patterns.

In the process, they found such metrics were more sensitive to picking up complications than the traditional metrics. In fact, in analyzing the data, scientists were able to retrospectively predict postoperative complications up to three days before formal diagnosis with 91 percent sensitivity and 74 percent specificity.

“Historically, we have been reliant upon subjective reporting from children — who often have greater difficulty articulating their symptoms — and their caregivers following hospital discharge. As a result, complications are not always caught right away,” said study author Dr. Fizan Abdullah, MD, PhD, a former attending physician of pediatric surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and professor of Surgery. “By using widely available wearables, coupled with this novel algorithm, we have an opportunity to change the paradigm of postoperative monitoring and care — and improve outcomes for kids in the process.”

What’s next?

This research is part of a four-year National Institutes of Health (NIH)-funded project. As a next step, scientists plan to transition this approach into a real-time (vs. retrospective) system that analyzes data automatically and sends alerts to children’s clinical teams.

“This study reinforces wearables’ potential to complement clinical care for better patient recoveries,” said Hassan M.K. Ghomrawi, PhD, vice chair of research and innovation in the Department of Orthopaedic Surgery at University of Alabama at Birmingham. “Our team is eager to enter the next phase of research exploration.”