The association between vital signs abnormalities during post-anaesthesia care unit stay and deterioration in the general ward following major abdominal cancer surgery assessed by continuous wireless monitoring

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Objective: Vital signs abnormalities in the post-anaesthesia care unit (PACU) may identify patients at risk of severe postoperative complications in the general ward, but are sparsely investigated by continuous monitoring. We aimed to assess if the severity of vital signs abnormalities in the PACU was correlated to the duration of severe vital signs abnormalities and serious adverse events (SAEs) in the general ward. Design: Prospective cohort study. Primary exposure was PACU vital signs abnormalities assessed by a standardised PACU recovery score. Participants: Adult patients, aged ≥ 60 years, who underwent major abdominal cancer surgery. Main outcome measures: The duration of severe vital signs abnormalities were assessed by continuous wireless vital signs monitoring and, secondly, by any SAE within the first 96 hours in the general ward. Results: One-hundred patients were included, and 92 patients with a median of 91 hours (interquartile range, 71–95 hours) of vital signs recording were analysed. The maximum vital signs abnormalities in the PACU were not significantly correlated to overall vital signs abnormalities in the general ward (R = 0.13; P = 0.22). Severe circulatory abnormalities in the overall PACU stay and at discharge were significantly correlated to the duration of circulatory vital signs abnormalities on the ward (R = 0.32 [P = 0.00021] and R = 0.26 [P = 0.014], respectively). Seventeen patients (18%) experienced SAEs, without significant association to the PACU stay (area under the receiver operating characteristic [AUROC], 0.59; 95% CI, 0.46–0.73). Conclusion: Vital signs abnormalities in the PACU did not show a tendency towards predicting overall severe vital signs abnormalities or SAEs during the first days in the general ward. Circulatory abnormalities in the PACU showed a tendency towards predicting circulatory complications in the ward.

OriginalsprogEngelsk
TidsskriftCritical Care and Resuscitation
Vol/bind24
Udgave nummer4
Sider (fra-til)330-340
Antal sider11
ISSN1441-2772
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
The WARD-project receives core support from the Novo Nordic Foundation; the Danish Cancer Society (R150-A9865-16-S48); Copenhagen Center for Health Technology (CACHET); Steno Diabetes Centers, Denmark; Radiometer; AP Møller Foundation, as well as cofunding from Bispebjerg and Frederiksberg Hospital, Rigshospitalet and the Technical University of Denmark. No industry partner had any role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. Christian Meyhoff, Eske Aasvang and Helge Sørensen have founded a start-up company, WARD247 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD-project (Wireless Assessment of Respiratory and Circulatory Distress, a project developing a clinical support system for continuous wireless monitoring of vital signs). WARD247 ApS has obtained license agreement for any WARD-project software and patents. One patent has been filed: “Wireless Assessment of Respiratory and circulatory Distress (WARD), EP 21184712.4 and EP 21205557.8”. In addition, Christian Meyhoff reports direct and indirect departmental research funding from Boehringer Ingelheim and Merck, Sharp and Dohme, as well as lecture fees from Radiometer. None of the above entities have influence on the study design, conduct, analysis or reporting.

Funding Information:
Acknowledgements: We thank Camilla Haahr-Raunkjær for initiation of the WARD-project data collection and Mette Ingemann Vincentz Søgaard for the inclusion of patients. The WARD-project has received grants from the Innovation Fund Denmark. Governance: We are aware of and comply with recognised codes of good research practice, including the Danish Code of Conduct for Research Integrity. We comply with national and international rules on the safety and rights of patients and healthy subjects, including Good Clinical Practice as defined in the European Union’s Directive on Good Clinical Practice, the International Conference on Harmonization’s good clinical practice guidelines and the Helsinki Declaration. We follow national and international rules on the processing of personal data, including the Danish Act on Processing of Personal Data and the practice of the Danish Data Inspectorate.

Publisher Copyright:
© 2022, College of Intensive Care Medicine. All rights reserved.

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