Recognition of early signs of deterioration in postoperative course could be improved by continuous monitoring of vital parameters. Wearable sensors could enable this by wireless transmission of vital signs. A novel accelerometer-based device, called Healthdot, has been designed to be worn on the skin to measure the two key vital parameters respiration rate (RespR) and heart rate (HeartR). The goal of this study is to assess the reliability of heart rate and respiration rate measured by the Healthdot in comparison to the gold standard, the bedside patient monitor, during the postoperative period in bariatric patients. Data were collected in a consecutive group of 30 patients who agreed to wear the device after their primary bariatric procedure. Directly after surgery, a Healthdot was attached on the patients’ left lower rib. Vital signs measured by the accelerometer based Healthdot were compared to vital signs collected with the gold standard patient monitor for the period that the patient stayed at the post-anesthesia care unit. Over all patients, a total of 22 hours of vital signs obtained by the Healthdot were recorded simultaneously with the bedside patient monitor data. 87.5% of the data met the pre-defined bias of 5 beats per minute for HeartR and 92.3% of the data met the pre-defined bias of 5 respirations per minute for RespR. The Healthdot can be used to accurately derive heart rate and respiration rate in postbariatric patients. Wireless continuous monitoring of key vital signs has the potential to contribute to earlier recognition of complications in postoperative patients. Future studies should focus on the ability to detect patient deterioration in low-care environments and at home after discharge from the hospital.
Background Postoperative deterioration is often preceded by abnormal vital parameters. Therefore, vital parameters of postoperative patients are routinely measured by nursing staff. Wrist-worn sensors could potentially provide an alternative tool for the measurement of vital parameters in low-acuity settings. These devices would allow more frequent or even continuous measurements of vital parameters without relying on time-consuming manual measurements, provided their accuracy in this clinical population is established. Objective This study aimed to assess the accuracy of heart rate (HR) and respiratory rate (RR) measures obtained via a wearable photoplethysmography (PPG) wristband in a cohort of postoperative patients. Methods The accuracy of the wrist-worn PPG sensor was assessed in 62 post–abdominal surgery patients (mean age 55, SD 15 years; median BMI 34, IQR 25-40 kg/m2). The wearable obtained HR and RR measurements were compared to those of the reference monitor in the postanesthesia or intensive care unit. Bland-Altman and Clarke error grid analyses were performed to determine agreement and clinical accuracy. Results Data were collected for a median of 1.2 hours per patient. With a coverage of 94% for HR and 34% for RR, the device was able to provide accurate measurements for the large majority of the measurements as 98% and 93% of the measurements were within 5 bpm or 3 rpm of the reference signal. Additionally, 100% of the HR and 98% of the RR measurements were clinically acceptable on Clarke error grid analysis. Conclusions The wrist-worn PPG device is able to provide measurements of HR and RR that can be seen as sufficiently accurate for clinical applications. Considering the coverage, the device was able to continuously monitor HR and report RR when measurements of sufficient quality were obtained. Trial Registration ClinicalTrials.gov NCT03923127; https://www.clinicaltrials.gov/ct2/show/NCT03923127
BACKGROUND Postoperative deterioration is often preceded by abnormal vital parameters. Therefore, vital parameters of postoperative patients are routinely measured by nursing staff. Wrist-worn sensors could potentially provide an alternative tool for the measurement of vital parameters in low-acuity settings. These devices would allow more frequent or even continuous measurements of vital parameters without relying on time-consuming manual measurements, provided their accuracy in this clinical population is established. OBJECTIVE This study aimed to assess the accuracy of heart rate (HR) and respiratory rate (RR) measures obtained via a wearable photoplethysmography (PPG) wristband in a cohort of postoperative patients. METHODS The accuracy of the wrist-worn PPG sensor was assessed in 62 post–abdominal surgery patients (mean age 55, SD 15 years; median BMI 34, IQR 25-40 kg/m<sup>2</sup>). The wearable obtained HR and RR measurements were compared to those of the reference monitor in the postanesthesia or intensive care unit. Bland-Altman and Clarke error grid analyses were performed to determine agreement and clinical accuracy. RESULTS Data were collected for a median of 1.2 hours per patient. With a coverage of 94% for HR and 34% for RR, the device was able to provide accurate measurements for the large majority of the measurements as 98% and 93% of the measurements were within 5 bpm or 3 rpm of the reference signal. Additionally, 100% of the HR and 98% of the RR measurements were clinically acceptable on Clarke error grid analysis. CONCLUSIONS The wrist-worn PPG device is able to provide measurements of HR and RR that can be seen as sufficiently accurate for clinical applications. Considering the coverage, the device was able to continuously monitor HR and report RR when measurements of sufficient quality were obtained. CLINICALTRIAL ClinicalTrials.gov NCT03923127; https://www.clinicaltrials.gov/ct2/show/NCT03923127
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