Wearable-derived postdischarge median daily step count was strongly associated with 90-day readmission (AUC 0.86) and mortality (AUC 0.83) in metastatic cancer, with a cutoff of 3013 steps/day identifying patients at substantially higher risk.
Key Findings
Results
A postdischarge median daily step count of 3013 steps/day was identified as the optimal cutoff for predicting 90-day unplanned readmission in patients with metastatic cancer.
ROC analysis was used to identify this threshold during a prespecified 14-day postdischarge landmark period
Patients with ≤3013 steps/day had a 73.0% readmission rate compared to 13.0% in those with higher activity (p < 0.001)
Patients with ≤3013 steps/day had a 47.0% mortality rate compared to 9.0% in those with higher activity (p < 0.001)
Study enrolled 200 evaluable adults with stage IV solid tumors discharged after unplanned hospitalization from two tertiary oncology centers
Results
Wearable-derived median daily step count demonstrated strong discrimination for both 90-day readmission and 90-day mortality.
AUC for 90-day readmission was 0.86
AUC for 90-day all-cause mortality was 0.83
Physical activity was assessed using a wrist-worn wearable device over a 14-day postdischarge landmark period
86 of 200 patients (43.0%) experienced unplanned readmission and 56 (28.0%) died within 90 days
Results
Low postdischarge step count remained independently associated with 90-day readmission in multivariable analysis.
Adjusted OR for readmission with low step count: 22.9 (95% CI 9.3–56.6)
This association persisted after adjustment for other variables in multivariable logistic regression
The low activity group was defined as ≤3013 steps/day
Results
Low postdischarge step count remained independently associated with 90-day all-cause mortality in multivariable analysis.
Adjusted HR for mortality with low step count: 5.46 (95% CI 2.54–11.74)
This association persisted after multivariable adjustment
Secondary outcome was 90-day all-cause mortality
Results
Higher postdischarge physical activity was associated with better patient-reported outcomes across multiple domains including quality of life, sleep, anxiety, and depression.
Higher activity was associated with better health-related quality of life, better sleep quality, 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
Associations were evaluated using validated patient-reported outcome measures
Patients were followed for 90 days postdischarge
Methods
The study was a prospective, two-center cohort study of adults with stage IV solid tumors following unplanned hospitalization.
200 evaluable patients were enrolled from two tertiary oncology centers
Inclusion criteria: adults with stage IV solid tumors discharged after unplanned hospitalization
Physical activity was measured using a wrist-worn wearable device during a prespecified 14-day postdischarge landmark period
Registered on ClinicalTrials.gov: NCT06687330
What This Means
This research suggests that simply counting the steps a cancer patient takes in the two weeks after leaving the hospital can predict whether they are likely to be readmitted or die within 90 days. Among 200 patients with advanced (stage IV) solid tumor cancers who were discharged after unexpected hospitalizations, those who walked fewer than about 3,000 steps per day had a 73% chance of being readmitted and a 47% chance of dying within 90 days — compared to only 13% and 9%, respectively, for those who were more active. A wrist-worn fitness tracker was used to objectively measure this activity over 14 days after discharge.
The step count threshold performed very well as a predictive tool, with accuracy scores (AUC) of 0.86 for readmission and 0.83 for mortality — meaning it correctly distinguished high-risk from low-risk patients most of the time. Importantly, low step count remained a strong predictor even after accounting for other factors, with patients in the low-activity group being nearly 23 times more likely to be readmitted and over 5 times more likely to die. Higher step counts were also linked to better quality of life, better sleep, and less anxiety and depression, with each additional 1,000 steps per day associated with improved scores across all of these measures.
This research suggests that wearable fitness devices could offer a practical, continuous, and patient-centered way to identify cancer patients who are at high risk after hospital discharge — potentially allowing healthcare teams to intervene earlier with supportive care. However, the authors note that external validation studies and prospective clinical trials are needed before this approach could be used to guide real-world treatment decisions.
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Akdogan O, Uyar G, Bergerot C, McCollom J, Tuzcu T, Yesilbas E, et al.. (2026). Wearable-derived postdischarge mobility as a digital biomarker for 90-day readmission and mortality in metastatic cancer.. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. https://doi.org/10.1007/s00520-026-11216-6