Outcomes in patients receiving continuous monitoring of vital signs on general wards: A systematic review and meta-analysis of randomised controlled trials.

OBJECTIVE

The timely identification of deterioration on general wards is crucial to patient care with each hour of delay independently associated with increased risk of death. The introduction of continuous monitoring of patient vital signs on general wards, currently not standard care, may improve patient outcomes. Our aim was to investigate whether patients on general wards receiving continuous vital signs monitoring have better outcomes than patients receiving usual care.

METHODS

Meta-analysis of randomised controlled trials comparing non-critical care patients receiving continuous monitoring of vital signs to usual care. We searched Medline, Embase, and Web of Science, and assessed risk of bias with version 2 of the Cochrane risk-of-bias tool for randomised trials. In addition to measures related to the early detection of deterioration, we planned to present all patient outcomes reported by the clinical trials included.

RESULTS

We included seven trials involving 1284 participants. There were no statistically significant differences in the four outcomes pooled. Comparing continuously monitored to normal care, the pooled odds for hospital mortality, major event/complication, and HDU/ICU admission was 0.95 (95% CI 0.59-1.53,  = 0.84; 660 participants, 3 studies), 0.71 (95% CI 0.38-1.31,  = 0.27; 948 participants, 4 studies) and 0.82 (95% CI 0.25-2.67,  = 0.74; 655 participants, 4 studies), respectively. The mean difference for length of stay was 2.12 days lower (95% CI -5.56 to 1.32,  = 0.23; 1034 participants, 6 studies).

CONCLUSION

We found no significant improvements in outcomes for patients continuously monitored compared to usual care. Further research is needed to understand what modalities of continuous monitoring may influence outcomes and investigate the implications of a telepresence service and multi-parameter scoring system.

REGISTRATION

PROSPERO CRD42023458656.