Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 10, 2024
Date Accepted: Jan 31, 2025
Continuous and wireless monitoring of vital signs on medical wards: Impact on patient outcomes
ABSTRACT
Background:
Continuous and wireless vital sign (VS) monitoring on hospital wards is superior to intermittent VS monitoring in detecting VS abnormalities; however, the impact on clinical outcomes remains to be confirmed.
Objective:
Evaluate and compare clinical outcomes in a large propensity matched medical ward population who received either continuous or as a contemporaneous control standard of care, intermittent VS monitoring every 4 to 8 hours. We hypothesized that earlier detection of VS aberrations through continuous VS monitoring would reduce ICU transfer and in-hospital mortality.
Methods:
Propensity matched analysis of a population-based sample of 7,971 patients admitted to the medical wards between January 2018 and December 2019 at a single, tertiary United States medical center. Patients received either 12 hours or more of continuous and wireless VS monitoring (n=1,450) or intermittent VS monitoring (n=6,521). Primary outcome was the odds of a composite of in-hospital mortality or ICU transfer during hospitalization. Secondary outcomes were the odds of individual components of the primary outcome, as well as heart failure (HF), myocardial infarction (MI), acute kidney injury (AKI), and rapid response team (RRT) activations.
Results:
Those who received intermittent VS monitoring had greater odds of a composite of in-hospital mortality or ICU admission (2.79, 95% CI: 1.89, 4.25, p<0.001) compared to those who had continuous and wireless VS monitoring. The odds of HF (1.03, 95% CI: 0.83, 1.28, p=0.768), MI (1.58, 95% CI: 0.77, 3.47, p=0.231), AKI (0.74, 95% CI: 0.62, 1.02, p=0.064), and rapid response team activation (0.94, 95% CI: 0.75, 1.19, p=0.623) were similar in both groups.
Conclusions:
In this propensity matched study, medical ward patients who received standard of care intermittent VS monitoring were at nearly two and half times greater odds of transfer to the ICU or death compared to those who received continuous VS monitoring. These observations need to be confirmed with prospective interventional trials. Clinical Trial: N/A
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.