Outcomes of vital sign monitoring of an acute surgical cohort with wearable sensors and digital alerting systems: a pragmatically designed cohort study and propensity-matched analysis

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Title: Outcomes of vital sign monitoring of an acute surgical cohort with wearable sensors and digital alerting systems: a pragmatically designed cohort study and propensity-matched analysis
Authors: Iqbal, F
Joshi, M
Fox, R
Tonia, K
Sharma, A
Wright, M
Khan, S
Ashrafian, H
Darzi, A
Item Type: Journal Article
Abstract: Background: The implementation and efficacy of wearable sensors and alerting systems in acute secondary care have been poorly described. Objectives: to pragmatically test one such system and its influence on clinical outcomes in an acute surgical cohort. Methods: In this pragmatically designed, pre-post implementation trial, participants admitted to the acute surgical unit at our institution were recruited. In the pre-implementation phase (September 2017 to May 2019), the SensiumVitals™ monitoring system, which continuously measures temperature, heart, and respiratory rates, was used for monitoring alongside usual care (intermittent monitoring in accordance with the National Early Warning Score 2 [NEWS 2] protocol) without alerts being generated. In the post-implementation phase (May 2019 to March 2020), alerts were generated when pre-established thresholds for vital parameters were breached, requiring acknowledgement from healthcare staff on provided mobile devices. Hospital length of stay, intensive care use, and 28-day mortality were measured. Balanced cohorts were created with 1:1 ‘optimal’ propensity score logistic regression models. Results: The 1:1 matching method matched the post-implementation group (n = 141) with the same number of subjects from the pre-implementation group (n = 141). The median age of the entire cohort was 52 (range: 18-95) years and the median duration of wearing the sensor was 1.3 (interquartile range: 0.7-2.0) days. The median alert acknowledgement time was 111 (range: 1-2146) minutes. There were no significant differences in critical care admission (planned or unplanned), hospital length of stay, or mortality. Conclusion: This study offered insight into the implementation of digital health technologies within our institution. Further work is required for optimisation of digital workflows, particularly given their more favourable acceptability in the post pandemic era. Clinical trials registration information: ClinicalTrials.gov Identifier: NCT04638738
Date of Acceptance: 6-Jun-2022
URI: http://hdl.handle.net/10044/1/97793
ISSN: 2296-4185
Publisher: Frontiers Media
Journal / Book Title: Frontiers in Bioengineering and Biotechnology
Volume: 10
Copyright Statement: © 2022 Iqbal, Joshi, Fox, Koutsoukou, Sharma, Wright, Khan, Ashrafian and Darzi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords: ambulatory
clinical trial
patient deterioration
patient deterioration detection
remote sensing technology
0699 Other Biological Sciences
0903 Biomedical Engineering
1004 Medical Biotechnology
Publication Status: Published
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine
Institute of Global Health Innovation

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