Clinical evaluation of a wearable sensor for mobile monitoring of respiratory rate on hospital wards

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Abstract

A wireless and wearable system was recently developed for mobile monitoring of respiratory rate (RR). The present study was designed to compare RR mobile measurements with reference capnographic measurements on a medical-surgical ward. The wearable sensor measures impedance variations of the chest from two thoracic and one abdominal electrode. Simultaneous measurements of RR from the wearable sensor and from the capnographic sensor (1 measure/minute) were compared in 36 ward patients. Patients were monitored for a period of 182 ± 56 min (range 68–331). Artifact-free RR measurements were available 81% of the monitoring time for capnography and 92% for the wearable monitoring system (p < 0.001). A total of 4836 pairs of simultaneous measurements were available for analysis. The average reference RR was 19 ± 5 breaths/min (range 6–36). The average difference between the wearable and capnography RR measurements was − 0.6 ± 2.5 breaths/min. Error grid analysis showed that the proportions of RR measurements done with the wearable system were 89.7% in zone A (no risk), 9.6% in zone B (low risk) and < 1% in zones C, D and E (moderate, significant and dangerous risk). The wearable method detected RR values > 20 (tachypnea) with a sensitivity of 81% and a specificity of 93%. In ward patients, the wearable sensor enabled accurate and precise measurements of RR within a relatively broad range (6–36 b/min) and the detection of tachypnea with high sensitivity and specificity.

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Mortality after surgery in Europe: a 7 day cohort study

Tamas Szakmany, Rupert M. Pearse, Rui P Moreno … (2012)

Summary Background Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe. Methods We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ2 and Fisher's exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries. Findings We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19–1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland). Interpretation The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients. Funding European Society of Intensive Care Medicine, European Society of Anaesthesiology.

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Multicenter Comparison of Machine Learning Methods and Conventional Regression for Predicting Clinical Deterioration on the Wards.

Matthew M. Churpek, Trevor Yuen, Christopher Winslow … (2016)

Machine learning methods are flexible prediction algorithms that may be more accurate than conventional regression. We compared the accuracy of different techniques for detecting clinical deterioration on the wards in a large, multicenter database.

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Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit.

Jerry P. Nolan, Jasmeet Soar, Gary B Smith … (2014)

To report the incidence, characteristics and outcome of adult in-hospital cardiac arrest in the United Kingdom (UK) National Cardiac Arrest Audit database. A prospectively defined analysis of the UK National Cardiac Arrest Audit (NCAA) database. 144 acute hospitals contributed data relating to 22,628 patients aged 16 years or over receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a 2222 call. The main outcome measures were incidence of adult in-hospital cardiac arrest and survival to hospital discharge. The overall incidence of adult in-hospital cardiac arrest was 1.6 per 1000 hospital admissions with a median across hospitals of 1.5 (interquartile range 1.2-2.2). Incidence varied seasonally, peaking in winter. Overall unadjusted survival to hospital discharge was 18.4%. The presenting rhythm was shockable (ventricular fibrillation or pulseless ventricular tachycardia) in 16.9% and non-shockable (asystole or pulseless electrical activity) in 72.3%; rates of survival to hospital discharge associated with these rhythms were 49.0% and 10.5%, respectively, but varied substantially across hospitals. These first results from the NCAA database describing the current incidence and outcome of adult in-hospital cardiac arrest in UK hospitals will serve as a benchmark from which to assess the future impact of changes in service delivery, organisation and treatment for in-hospital cardiac arrest. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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Frederic Michard:

ORCID: http://orcid.org/0000-0001-9749-3515

frederic.michard@bluewin.ch

Journal

Journal ID (nlm-ta): J Clin Monit Comput

Journal ID (iso-abbrev): J Clin Monit Comput

Title: Journal of Clinical Monitoring and Computing

Publisher: Springer Netherlands (Dordrecht )

ISSN (Print): 1387-1307

ISSN (Electronic): 1573-2614

Publication date (Electronic): 2 September 2021

Publication date PMC-release: 2 September 2021

Publication date (Print): 2022

Volume: 36

Issue: 1

Pages: 81-86

Affiliations

[1 ]GRID grid.488240.2, ISNI 0000 0004 0409 6409, Research & Development, , GE Healthcare, ; Helsinki, Finland

[2 ]MiCo, Denens, Switzerland

[3 ]GRID grid.15485.3d, ISNI 0000 0000 9950 5666, Department of Anesthesia, Intensive Care and Pain Medicine, , Helsinki University Hospital and University of Helsinki, ; Helsinki, Finland

Author information

Frederic Michard http://orcid.org/0000-0001-9749-3515

Article

Publisher ID: 753

DOI: 10.1007/s10877-021-00753-6

PMC ID: 8894146

PubMed ID: 34476669

SO-VID: 36e87ed8-30ed-4901-8939-e70e5a8b1b2e

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Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 14 June 2021

Date accepted : 27 August 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100006775, GE Healthcare;

Award ID: HUS/3008/2018

Award Recipient : Leena Vikatmaa

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ScienceOpen disciplines: Medicine

Keywords: ward monitoring,wireless monitoring,remote monitoring,wearable sensor,respiratory frequency,thoracic impedance

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ScienceOpen disciplines: Medicine

Keywords: ward monitoring, wireless monitoring, remote monitoring, wearable sensor, respiratory frequency, thoracic impedance

Clinical evaluation of a wearable sensor for mobile monitoring of respiratory rate on hospital wards

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Most cited references 24

Mortality after surgery in Europe: a 7 day cohort study

Multicenter Comparison of Machine Learning Methods and Conventional Regression for Predicting Clinical Deterioration on the Wards.

Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit.

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