早期预警得分以支持持续无线生命体征监测,以预测外科病房患者的并发症:回顾性观察性研究
Mathilde C van Rossum1,2, Robin E M Bekhuis3,4, Ying Wang1,4
1Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.
JMIR perioperative medicine
|August 30, 2023
概括
无线传感器可以通过使用连续早期预警分数 (EWS) 改善患者病情恶化的早期检测,优于手动EWS测量,但需要仔细设置值来管理错误报警.
科学领域:
- 医疗监控技术 医疗监控技术
- 手术患者护理手术患者护理
- 恶化检测检测恶化的检测.
背景情况:
- 无线生命体征传感器在外科病房越来越多地使用.
- 早期预警分数 (EWS) 是患者病情恶化的标准,但其持续监测实用性尚不清楚.
研究的目的:
- 从连续生命体征数据中评估高速率EWS的可用性和预测价值.
- 将基于传感器的EWS报警与手动EWS和单参数报警进行比较,以识别术后并发症.
主要方法:
- 从连续的无线生命体征数据 (心率,呼吸率,氧和度,温度) 进行回溯模拟的每小时传感器EWS.
- 在患有和没有术后并发症的患者之间比较传感器EWS.
- 对传感器EWS与手动EWS和单参数报警相比,评估了传感器EWS的报警性能 (灵敏度,报警率,错误发现率).
主要成果:
- 在患有术后并发症的患者中,每小时传感器EWS显著更高 (中位数3.4),而不是对照组 (中位数2.8).
- 传感器 EWS 报警显示,对于 3-5 个值,其灵敏度比手动 EWS 报警 (最大 40%) 高 (80%-67%).
- 传感器EWS报警的错误报警率高于手动EWS,但低于单参数报警.
结论:
- 使用无线生命体征传感器和EWS的持续监测显示,对早期识别术后并发症有很大的希望.
- 基于传感器的EWS提供了比手动测量更好的报警灵敏度.
- 优化报警值至关重要,以平衡灵敏度,减少在持续监控中高错误报警率.
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