Abstract
Rationale: Postoperative complications after colorectal surgery, such as anastomotic leakage (AL), significantly increase patient morbidity and mortality. Early detection and treatment are crucial for improving patient outcomes. Continuous vital sign monitoring enables earlier alarming based on changes in patient vital signs. This study investigates the potential of continuous heart rate (HR) and respiratory rate (RR) monitoring, to facilitate early detection of AL without increasing alarm fatigue.
Methods: A retrospective analysis was conducted on continuous HR and RR measured with the Philips HealthDot, collected over 14 days postoperatively, from patients who underwent elective oncological colorectal surgery. HR and RR from patients with AL were compared to those without complications. A novel trend analysis of the continuous HR is compared to the golden standard a threshold-based alarming; the Remote Early Warning Score (REWS). An alarm is generated in the novel trend-based method when the moving average of 24 hours of HR data is larger than 8 beats per minute over 4 hours and the derivative is positive. The two methods were compared based on the numbers of false positives (FP) in patients without complications and time of first alarm in hours before CT-scan.
Results: The REWS is compared to the trend alarming of data from two patients with AL and six patients without complications. The REWS methods alarmed 72 and 8 hours prior to diagnosis with two false positive alarms, while the trend-based strategy alarmed 87 and 10 hours before diagnosis with no false positives. In one patient, both methods alarmed prior to onset of postoperative complication symptoms.
Conclusions: This small proof-of-principle study demonstrates the potential of continuous vital sign monitoring for early detection of AL after colorectal resection, both in-hospital and at home. Trend-based method alarmed earlier than REWS, without false positives. Although limited by the small sample size, these findings support further investigation into personalized alarms based on trend analysis of continuously measured HR as an effective method for early detection of AL after colorectal resections.
Methods: A retrospective analysis was conducted on continuous HR and RR measured with the Philips HealthDot, collected over 14 days postoperatively, from patients who underwent elective oncological colorectal surgery. HR and RR from patients with AL were compared to those without complications. A novel trend analysis of the continuous HR is compared to the golden standard a threshold-based alarming; the Remote Early Warning Score (REWS). An alarm is generated in the novel trend-based method when the moving average of 24 hours of HR data is larger than 8 beats per minute over 4 hours and the derivative is positive. The two methods were compared based on the numbers of false positives (FP) in patients without complications and time of first alarm in hours before CT-scan.
Results: The REWS is compared to the trend alarming of data from two patients with AL and six patients without complications. The REWS methods alarmed 72 and 8 hours prior to diagnosis with two false positive alarms, while the trend-based strategy alarmed 87 and 10 hours before diagnosis with no false positives. In one patient, both methods alarmed prior to onset of postoperative complication symptoms.
Conclusions: This small proof-of-principle study demonstrates the potential of continuous vital sign monitoring for early detection of AL after colorectal resection, both in-hospital and at home. Trend-based method alarmed earlier than REWS, without false positives. Although limited by the small sample size, these findings support further investigation into personalized alarms based on trend analysis of continuously measured HR as an effective method for early detection of AL after colorectal resections.
| Original language | English |
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| Publication status | Published - 30 Jan 2025 |
| Event | 10th Dutch Biomedical Engineering Conference, BME 2025 - Hotel Zuiderduin, Egmond aan Zee, Netherlands Duration: 30 Jan 2025 → 31 Jan 2025 Conference number: 10 https://www.bme2025.nl/ |
Conference
| Conference | 10th Dutch Biomedical Engineering Conference, BME 2025 |
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| Abbreviated title | BME 2025 |
| Country/Territory | Netherlands |
| City | Egmond aan Zee |
| Period | 30/01/25 → 31/01/25 |
| Internet address |