格林线医院-地域研究：内科连续无线监测技术挑战评估的单盲随机临床试验，初步结果。

Green Line Hospital-Territory Study: A Single-Blind Randomized Clinical Trial for Evaluation of Technological Challenges of Continuous Wireless Monitoring in Internal Medicine, Preliminary Results.

机构信息

Internal Medicine Unit, Ospedale dei Castelli, ASL Roma 6, Va Nettunense, 00043 Rome, Italy.

School of Hygiene and Preventive Medicine, University of Rome "Tor Vergata", 00100 Rome, Italy.

出版信息

Int J Environ Res Public Health. 2021 Sep 30;18(19):10328. doi: 10.3390/ijerph181910328.

BACKGROUND

Wireless vital parameter continuous monitoring (WVPCM) after discharge is compared to regular monitoring to provide data on the clinical-economic impact of complex patients (CPs) discharged from Internal Medicine Units of Ospedale dei Castelli, Lazio.

PRIMARY OUTCOME

Major complications (MC) reduction.

SECONDARY OUTCOMES

Patients who reached discharge criteria within the 7th day from admission; difference in MC incidence at the conclusion of the standard telemonitoring/clinical monitoring phase, 5 and 30 days after discharge; and conditions predisposing to MC occurrence.

METHODS

Open label randomized controlled trial with wearable wireless system that creates alerts on portable devices. Continuous glycemic monitoring is performed for patients with diabetes mellitus.

RESULTS

There were 110 patients enrolled (mean age: 76.2 years). Comorbidity: Cumulative Illness Rating Scale CIRS-CI (comorbidities index): 3.93, CIRS SI (severity index): 1.93. About 19% scored a BRASS (Blaylock Risk Assessment Screening Score) ≥20 indicating need for discharge planning requiring step-down care. Globally, 48% of patients in the control group had major complications (27 out of 56 patients), in contrast to 22% in the intervention group (12 out of 54 patients).

CONCLUSIONS

Since WVPCM detects early complications during the post-discharge CPs monitoring, it increases safety and reduces inappropriate access to the Emergency Room, preventing avoidable re-hospitalizations.

背景

无线生命参数连续监测（WVPCM）在出院后与常规监测进行比较，以提供有关从拉齐奥 Ospedale dei Castelli 内科病房出院的复杂患者（CPs）的临床经济效益的数据。

主要结果

减少主要并发症（MC）。

次要结果

在入院后第 7 天达到出院标准的患者；在标准远程监测/临床监测阶段结束时、出院后 5 天和 30 天时 MC 发生率的差异；以及易发生 MC 的情况。

方法

开放标签随机对照试验，使用可穿戴无线系统在便携式设备上创建警报。对糖尿病患者进行连续血糖监测。

结果

共纳入 110 例患者（平均年龄：76.2 岁）。合并症：累积疾病评分量表 CIRS-CI（合并症指数）：3.93，CIRS SI（严重程度指数）：1.93。约 19%的患者 BRASS（Blaylock 风险评估筛查评分）≥20，表明需要进行出院计划，需要逐步降低护理水平。在对照组中，48%的患者发生主要并发症（56 例中有 27 例），而干预组为 22%（54 例中有 12 例）。