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住院患者可穿戴生命体征监测的完整性、准确性及其对警报的影响。

The completeness, accuracy and impact on alerts, of wearable vital signs monitoring in hospitalised patients.

作者信息

Wilson Anthony J, Parker Alexander J, Kitchen Gareth B, Martin Andrew, Hughes-Noehrer Lukas, Nirmalan Mahesh, Peek Niels, Martin Glen P, Thistlethwaite Fiona C

机构信息

Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.

Adult Critical Care, Manchester University NHS Foundation Trust, Manchester, UK.

出版信息

BMC Digit Health. 2025;3(1):13. doi: 10.1186/s44247-025-00151-x. Epub 2025 Apr 15.

DOI:10.1186/s44247-025-00151-x

PMID:40242279

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11997001/

Abstract

BACKGROUND

Use of wearable vital signs sensors (WVSSs) to monitor hospitalised patients is growing but uncertainty exists about how such sensors should be adopted into existing practice. The aim of this observational study was to determine the completeness of data capture and accuracy of measurements recorded by a suite of WVSSs. The implications of using such measurements to derive early warning scores was also assessed.

METHODS

Adult inpatients with Covid-19 wore four WVSSs recording heart rate/respiratory rate (HR/RR), oxygen saturation (SpO), axillary temperature and blood pressure (BP). Wearable vitals were paired with traditional vitals (measured by nurses) recorded concurrently. The accuracy of the wearable vitals was assessed using traditional vitals as the reference. National early warning (NEWS2) scores were calculated using wearable and traditional vitals.

RESULTS

Forty-eight patients were monitored for 204 days with the sensors. Median sensor wear was 3.9(IQR:1.7-5.9), 3.9(IQR:1.6-5.9) and 3.8(IQR:0.9-5.9) days for HR/RR, temperature and SpO respectively. The BP cuff was worn for median 1.9(IQR:0.9-3.8) days in 33 patients. Length of hospital stay was 8(IQR:6-13) days. Completeness of data capture was 84% for HR/RR, 98% for temperature, 72% for SpO and 36% for BP.There were 1633 HR, 1614 RR, 1412 temperature, 1294 SpO and 59 BP wearable-traditional measurement pairs. 59.7% of HR pairs were within ± 5 bpm, 38.5% of RR pairs within ± 3breaths/min, 24.4% of temperature pairs within ± 0.3℃, 32.9% of SpO pairs within ± 2% and 39.0% of BP pairs within ± 10 mmHg. Agreement between wearable and traditional RRs was poor at high RRs.In a ward setting, 613 NEWS2 scores were calculated using wearable-traditional HR, RR, temperature and SpO pairs. The median NEWS2 was 1(IQR:1-2) and the median NEWS2 was 4(IQR:3-6). Using traditional NEWS2 alerts as a reference, 86% (225/262) of wearable NEWS2 5 + alerts and 89% (82/92) of wearable NEWS2 7 + alerts were false positives.

CONCLUSIONS

Agreement between vital signs recorded by wearable sensors and concurrent traditional vitals is poor. In this context, data from wearable sensors should not be used in existing track and trigger systems.

TRIAL REGISTRATION

The COSMIC-19 study was registered with clinicaltrials.gov (registration: NCT04581031, date of registration: Oct 6th 2020).

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s44247-025-00151-x.

摘要

背景

可穿戴生命体征传感器（WVSSs）在住院患者监测中的应用日益广泛，但对于如何将此类传感器纳入现有临床实践仍存在不确定性。这项观察性研究的目的是确定一套WVSSs所记录数据的完整性以及测量的准确性。同时还评估了使用这些测量值得出早期预警分数的意义。

方法

患有新冠-19的成年住院患者佩戴了四种WVSSs，用于记录心率/呼吸频率（HR/RR）、血氧饱和度（SpO）、腋温及血压（BP）。可穿戴生命体征数据与同时记录的传统生命体征数据（由护士测量）进行配对。以传统生命体征数据作为参考，评估可穿戴生命体征数据的准确性。使用可穿戴和传统生命体征数据计算国家早期预警（NEWS2）分数。

结果

使用传感器对48名患者进行了204天的监测。HR/RR、体温和SpO的传感器佩戴时间中位数分别为3.9（四分位间距：1.7 - 5.9）、3.9（四分位间距：1.6 - 5.9）和3.8（四分位间距：0.9 - 5.9）天。33名患者中血压袖带的佩戴时间中位数为1.9（四分位间距：0.9 - 3.8）天。住院时间为8（四分位间距：6 - 13）天。HR/RR的数据捕获完整性为84%，体温为98%，SpO为72%，血压为36%。共有1633对HR、1614对RR、1412对体温、1294对SpO以及59对血压的可穿戴 - 传统测量数据对。59.7%的HR数据对在±5次/分钟范围内，38.5%的RR数据对在±3次/分钟范围内，24.4%的体温数据对在±0.3℃范围内，32.9%的SpO数据对在±2%范围内，39.0%的血压数据对在±10mmHg范围内。RR值较高时，可穿戴和传统RR之间的一致性较差。在病房环境中，使用可穿戴 - 传统的HR、RR、体温和SpO数据对计算了613个NEWS2分数。NEWS2中位数为1（四分位间距：1 - 2），而使用传统数据计算的NEWS2中位数为4（四分位间距：3 - 6）。以传统NEWS2警报为参考，可穿戴NEWS2 5+警报中有86%（225/262）以及可穿戴NEWS2 7+警报中有89%（82/92）为误报。