PDF(Pubmed)
Abstract：
In Acute Admission Wards, vital signs are commonly measured only intermittently. This may result in failure to detect early signs of patient deterioration and impede timely identification of patient stability, ultimately leading to prolonged stays and avoidable hospital admissions. Therefore, continuous vital sign monitoring may improve hospital efficacy. The objective of this randomized controlled trial was to evaluate the effect of continuous monitoring on the proportion of patients safely discharged home directly from an Acute Admission Ward. Patients were randomized to either the control group, which received usual care, or the sensor group, which additionally received continuous monitoring using a wearable sensor. The continuous measurements could be considered in discharge decision-making by physicians during the daily bedside rounds. Safe discharge was defined as no unplanned readmissions, emergency department revisits or deaths, within 30 days after discharge. Additionally, length of stay, the number of Intensive Care Unit admissions and Rapid Response Team calls were assessed. In total, 400 patients were randomized, of which 394 completed follow-up, with 196 assigned to the sensor group and 198 to the control group. The proportion of patients safely discharged home was 33.2% in the sensor group and 30.8% in the control group (p = 0.62). No significant differences were observed in secondary outcomes. The trial was terminated prematurely due to futility. In conclusion, continuous monitoring did not have an effect on the proportion of patients safely discharged from an Acute Admission Ward. Implementation challenges of continuous monitoring may have contributed to the lack of effect observed. Trial registration: https://clinicaltrials.gov/ct2/show/NCT05181111 . Registered: January 6, 2022.
摘要：
在急性入院病房，生命体征通常仅间歇性测量。这可能导致无法发现患者恶化的早期迹象，并阻碍及时识别患者的稳定性，最终导致长期住院和可避免的住院。因此,连续的生命体征监测可以提高医院的疗效。这项随机对照试验的目的是评估连续监测对直接从急性入院病房安全出院的患者比例的影响。患者被随机分为对照组，接受常规护理，或传感器组，它还使用可穿戴传感器接受了连续监测。在每日床边巡视期间，医生可以在出院决策中考虑连续测量。安全出院被定义为没有计划外的再入院，急诊科重访或死亡，出院后30天内。此外,逗留时间,评估了重症监护病房的入院次数和快速反应小组的电话。总的来说,400名患者被随机分配,其中394人完成了随访，196分配给传感器组，198分配给控制组。传感器组安全出院的患者比例为33.2％，对照组为30.8％（p=0.62）。在次要结果中没有观察到显著差异。由于无效，该试验过早终止。总之,持续监测对急性入院病房安全出院的患者比例无影响.持续监测的实施挑战可能导致缺乏观察到的效果。试用注册：https://clinicaltrials.gov/ct2/show/NCT05181111。注册日期：2022年1月6日。
