TY - JOUR

T1 - Deviating vital signs in continuous monitoring prior to discharge and risk of readmission

T2 - an observational study

AU - Songthawornpong, Nicharatch

AU - Elvekjaer, Mikkel

AU - Mølgaard, Jesper

AU - Rasmussen, Søren M.

AU - Meyhoff, Christian S.

AU - Aasvang, Eske K.

AU - Eriksen, Vibeke R.

N1 - Publisher Copyright: © 2023, The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

PY - 2023/8

Y1 - 2023/8

N2 - Premature discharge may result in readmission while longer hospitalization may increase risk of complications such as immobilization and reduce hospital capacity. Continuous monitoring detects more deviating vital signs than intermittent measurements and may help identify patients at risk of deterioration after discharge. We aimed to investigate the association between deviating vital signs detected by continuous monitoring prior to discharge and risk of readmission within 30 days. Patients undergoing elective major abdominal surgery or admitted with acute exacerbation of chronic obstructive pulmonary disease were included in this study. Eligible patients had vital signs monitored continuously within the last 24 h prior to discharge. The association between sustained deviated vital signs and readmission risk was analyzed by using Mann–Whitney’s U test and Chi-square test. A total of 51 out of 265 patients (19%) were readmitted within 30 days. Deviated respiratory vital signs occurred frequently in both groups: desaturation < 88% for at least ten minutes was seen in 66% of patients who were readmitted and in 62% of those who were not (p = 0.62) while desaturation < 85% for at least five minutes was seen in 58% of readmitted and 52% of non-readmitted patients (p = 0.5). At least one sustained deviated vital sign was detected in 90% and 85% of readmitted patients and non-readmitted patients, respectively (p = 0.2). Deviating vital signs prior to hospital discharge were frequent but not associated with increased risk of readmission within 30 days. Further exploration of deviating vital signs using continuous monitoring is needed.

AB - Premature discharge may result in readmission while longer hospitalization may increase risk of complications such as immobilization and reduce hospital capacity. Continuous monitoring detects more deviating vital signs than intermittent measurements and may help identify patients at risk of deterioration after discharge. We aimed to investigate the association between deviating vital signs detected by continuous monitoring prior to discharge and risk of readmission within 30 days. Patients undergoing elective major abdominal surgery or admitted with acute exacerbation of chronic obstructive pulmonary disease were included in this study. Eligible patients had vital signs monitored continuously within the last 24 h prior to discharge. The association between sustained deviated vital signs and readmission risk was analyzed by using Mann–Whitney’s U test and Chi-square test. A total of 51 out of 265 patients (19%) were readmitted within 30 days. Deviated respiratory vital signs occurred frequently in both groups: desaturation < 88% for at least ten minutes was seen in 66% of patients who were readmitted and in 62% of those who were not (p = 0.62) while desaturation < 85% for at least five minutes was seen in 58% of readmitted and 52% of non-readmitted patients (p = 0.5). At least one sustained deviated vital sign was detected in 90% and 85% of readmitted patients and non-readmitted patients, respectively (p = 0.2). Deviating vital signs prior to hospital discharge were frequent but not associated with increased risk of readmission within 30 days. Further exploration of deviating vital signs using continuous monitoring is needed.

KW - Continuous monitoring

KW - Discharge

KW - Readmission

KW - Sustained deviated vital sign

KW - Vital signs

UR - http://www.scopus.com/inward/record.url?scp=85162057505&partnerID=8YFLogxK

U2 - 10.1007/s11739-023-03318-4

DO - 10.1007/s11739-023-03318-4

M3 - Journal article

C2 - 37326796

AN - SCOPUS:85162057505

VL - 18

SP - 1453

EP - 1461

JO - Internal and Emergency Medicine

JF - Internal and Emergency Medicine

SN - 1828-0447

IS - 5

ER -