Eddahchouri Yassin, Peelen Roel V, Koeneman Mats, Touw Hugo R W, van Goor Harry, Bredie Sebastian J H
Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Br J Anaesth. 2022 May;128(5):857-863. doi: 10.1016/j.bja.2022.01.036. Epub 2022 Mar 11.
Continuous vital sign monitoring may potentially be improved through the use of wearable monitors linked wirelessly to hospital electronic patient records. By improving early detection of physiological deterioration this approach may save lives.
We performed a single-centre before-and-after study including surgical and medical patients at a university hospital in The Netherlands. The study intervention was continuous vital sign monitoring using wearable monitors linked wirelessly to hospital systems. The co-primary outcomes were unplanned ICU admission and rapid response team calls. Secondary outcomes were length of hospital stay and in-patient death.
Our baseline cohort included 2466 admissions and our intervention cohort included 2303 admissions recruited from August 2017 to July 2019. Patients in the intervention cohort experienced fewer unplanned ICU admissions (84 [3.4%] vs 54 [2.3%]; P=0.03) and fewer rapid response team calls (107 [4.3%] vs 71 [3.1%]; P=0.02). The number of rapid response team calls that did not result in ICU admission also declined (70 [2.8%] vs 45 [2.0%]; P=0.05). The number of rapid response team calls that did result in ICU admission was not significantly different (52 [2.1%] vs 36 [1.6%]; P=0.16). There were no differences in hospital stay or in-patient deaths between the two study periods.
Continuous monitoring of patient vital signs using wearable monitoring technology linked wirelessly to hospital systems was associated with a reduction in unplanned ICU admissions and rapid response team calls. Further research is necessary to confirm the impact of this approach on patient survival.
通过使用与医院电子病历无线连接的可穿戴监测设备，持续生命体征监测可能会得到改善。通过改善对生理恶化的早期检测，这种方法可能会挽救生命。
我们在荷兰一家大学医院进行了一项单中心前后对照研究，纳入了外科和内科患者。研究干预措施是使用与医院系统无线连接的可穿戴监测设备进行持续生命体征监测。共同主要结局是意外入住重症监护病房（ICU）和快速反应小组呼叫。次要结局是住院时间和住院死亡。
我们的基线队列包括2466例入院患者，干预队列包括2017年8月至2019年7月招募的2303例入院患者。干预队列中的患者意外入住ICU的次数较少（84例[3.4%]对54例[2.3%]；P=0.03），快速反应小组呼叫次数也较少（107例[4.3%]对71例[3.1%]；P=0.02）。未导致入住ICU的快速反应小组呼叫次数也有所下降（70例[2.8%]对45例[2.0%]；P=0.05）。导致入住ICU的快速反应小组呼叫次数没有显著差异（52例[2.1%]对36例[1.6%]；P=0.16）。两个研究期间的住院时间或住院死亡情况没有差异。
使用与医院系统无线连接的可穿戴监测技术持续监测患者生命体征，与意外入住ICU和快速反应小组呼叫次数减少有关。需要进一步研究来证实这种方法对患者生存的影响。
