A randomised controlled trial of the effect of continuous electronic physiological monitoring on the adverse event rate in high risk medical and surgical patients
A randomised controlled trial of the effect of continuous electronic physiological monitoring on the adverse event rate in high risk medical and surgical patients
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DOI：
10.1111/j.1365-2044.2006.04818.x
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发表时间：
2006-11-01
期刊：
影响因子：
10.7
通讯作者：
Young, J. D.
中科院分区：
文献类型：
--
作者：
Watkinson, P. J.;Barber, V. S.;Young, J. D.
我们在英国一家教学医院的急诊内科和外科病房进行了一项强制性五通道生理监测与标准护理的随机对照试验。总共研究了402名高风险的内科和外科患者。主要结局是随机化后96小时内发生一种或多种主要不良事件的患者比例，包括紧急工作人员呼叫、更高护理水平的变化、心脏骤停或死亡。次要结局是需要急性治疗变化的患者比例，以及30天和住院死亡率。在随机化后96小时内，监测组113例（56%）患者和对照组116例（58%）患者（OR 0.94，95% CI 0.63-1.40，p = 0.76）发生重大事件。107例（53%）监测患者和101例（50%）对照患者需要立即改变治疗（OR 0.55，95% CI 0.87-1.29）。34例（17%）监测患者和35例（17%）对照患者在30天内死亡。对照组13例患者在病房工作人员的要求下接受全五通道监护。我们的结论是，强制电子生命体征监测高风险的医疗和手术患者对不良事件或死亡率没有影响。
We conducted a randomised controlled trial of mandated five-channel physiological monitoring vs standard care, in acute medical and surgical wards in a single UK teaching hospital. In all, 402 high-risk medical and surgical patients were studied. The primary outcome was the proportion of patients experiencing one or more major adverse events, including urgent staff calls, changes to higher care levels, cardiac arrests or death, in 96 h following randomisation. Secondary outcomes were the proportion of patients requiring acute treatment changes, and the 30-day and hospital mortality. In the 96 h following randomisation, 113 (56%) patients in the monitored arm and 116 (58%) in the control arm (OR 0.94, 95% CI 0.63-1.40, p = 0.76) had a major event. An acute change in treatment was necessary in 107 (53%) monitored patients and 101 (50%) control patients (OR 0.55, 95% CI 0.87-1.29). Thirty-four (17%) monitored patients and 35 (17%) control patients died within 30 days. Thirteen patients in the control group received full five-channel monitoring at the request of the ward staff. We conclude that mandated electronic vital signs monitoring in high risk medical and surgical patients has no effect on adverse events or mortality.