Continuous Monitoring of Vital Signs After Hospital Discharge: A Feasibility Study

Author:

Songthawornpong Nicharatch12,Vijayakumar Thivya12,Vang Jensen Marie Said3,Elvekjaer Mikkel12,Sørensen Helge B. D.4,Aasvang Eske K.56,Meyhoff Christian S.126,Eriksen Vibeke R.5

Affiliation:

1. Copenhagen University Hospital - Bispebjerg and Frederiksberg

2. Copenhagen Center for Translational Research, Copenhagen University Hospital, Bispebjerg and Frederiksberg

3. Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet

4. Technical University of Denmark

5. Copenhagen University Hospital - Rigshospitalet

6. University of Copenhagen

Abstract

Introduction Increasing demand for inpatient beds limits capacity and poses a challenge to the healthcare system. Early discharge may be one solution to solve this problem, and continuous vital sign monitoring at home could safely facilitate this goal. We aimed to document feasibility of continuous home monitoring in patients after hospital discharge. Methods Patients were eligible for inclusion if they were admitted with acute medical disease and scheduled for discharge. They wore three wireless vital sign sensors for four days at home: a chest patch measuring heart rate and respiratory rate, a pulse oximeter, and a blood pressure (BP) monitor. Patients with ≥6 hours monitoring time after discharge were included in the analysis. Primary outcome was percentage of maximum monitoring time of heart rate and respiratory rate. Results Monitoring was initiated in 80 patients, and 69 patients (86%) had ≥6 hours monitoring time after discharge. The chest patch, pulse oximeter, and BP monitor collected data for 88%, 60%, and 32% of the monitored time, respectively. Oxygen desaturation <88% was observed in 92% of the patients and lasted for 6.3% (interquartile range [IQR] 0.9%–22.0%) of total monitoring time. Desaturation below 85% was observed in 83% of the patients and lasted 4.2% [IQR 0.4%–9.4%] of total monitoring time. 61% had tachypnea (>24/minute); tachycardia (>130/minute) lasting ≥30 minutes was observed in 28% of the patients. Conclusions Continuous monitoring of vital signs was feasible at home with a high degree of valid monitoring time. Oxygen desaturation was commonly observed.

Publisher

Patient Safety Authority

Subject

General Medicine

Reference27 articles.

1. Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial;David M. Levine;Annals of Internal Medicine,2020

2. One Small Wearable, One Giant Leap for Patient Safety?;Frederic Michard;Journal of Clinical Monitoring and Computing,2022

3. Using the Clinical Frailty Scale in Allocating Scarce Health Care Resources;Kenneth Rockwood;Canadian Geriatrics Journal,2020

4. A Global Clinical Measure of Fitness and Frailty in Elderly People;K. Rockwood;Canadian Medical Association Journal,2005

5. Continuous vital sign monitoring after major abdominal surgery-Quantification of micro events;C. L. Duus;Acta Anaesthesiologica Scandinavica,2018

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