Wearable-derived postdischarge mobility as a digital biomarker for 90-day readmission and mortality in metastatic cancer.

Authors

Orhun Akdogan, Galip Can Uyar, Cristiane Decat Bergerot, Joseph W McCollom, Tuba Ugur Tuzcu, Enes Yesilbas, Fatih Umunc, Kadriye Baskurt, Gozde Savas, Ozgen Ahmet Yildirim, Fatih Gurler, Kadriye Bir Yucel, Ugur Coskun, Aytug Uner, Ahmet Ozet, Ozan Yazici, Nuriye Ozdemir, Berna Oksuzoglu, Osman Sutcuoglu

Published in

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. Volume 34. Issue 10. Sep 11, 2026. Epub Sep 11, 2026.

Abstract

The postdischarge period after unplanned hospitalization is a vulnerable transition for patients with metastatic cancer, often accompanied by functional decline, symptom burden, psychological distress, early readmission, and death. However, short-term risk assessment during this period still relies largely on episodic clinician-rated measures. We evaluated whether wearable-derived postdischarge step counts are associated with 90-day readmission, mortality, and patient-reported outcomes in patients with metastatic cancer.
In this prospective, two-center cohort study, adults with stage IV solid tumors discharged after unplanned hospitalization from two tertiary oncology centers were followed for 90 days. Physical activity was assessed using a wrist-worn wearable device, and median daily step count during a prespecified 14-day postdischarge landmark period was used as the main exposure. The primary outcome was unplanned 90-day readmission, and the secondary outcome was 90-day all-cause mortality. Associations with health-related quality of life, sleep quality, anxiety, and depressive symptoms were also evaluated using validated patient-reported outcome measures.
Among 200 evaluable patients, 86 (43.0%) experienced unplanned readmission and 56 (28.0%) died within 90 days. Receiver operating characteristic analysis identified 3013 steps/day as the optimal cutoff for 90-day readmission. Patients with lower postdischarge activity (≤ 3013 steps/day) had substantially higher readmission (73.0% vs 13.0%) and mortality (47.0% vs 9.0%) rates than those with higher activity (both p < 0.001). In multivariable analysis, low step count remained independently associated with readmission (adjusted OR 22.9, 95% CI 9.3-56.6) and mortality (HR 5.46, 95% CI 2.54-11.74). Median daily step count demonstrated strong discrimination for 90-day readmission (AUC 0.86) and mortality (AUC 0.83). Higher postdischarge activity was also associated with better quality of life, better sleep, and lower anxiety and depressive symptom burden. Each 1000-step increase was associated with lower odds of poor sleep quality, clinically significant anxiety, and depressive symptoms.
Wearable-derived postdischarge mobility was strongly associated with short-term clinical outcomes and supportive care-relevant patient-reported outcomes in metastatic cancer. These findings support further evaluation of objective activity monitoring as a scalable, patient-centered approach to postdischarge risk stratification. External validation and prospective interventional studies are needed before wearable-derived mobility measures can be used to guide supportive care strategies.
ClinicalTrials.gov Identifier: NCT06687330.

PMID:
42726154
Bibliographic data and abstract were imported from PubMed on 12 Sep 2026.

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