Wearable devices used as part of Continuous Remote Early Warning Score systems in the postoperative period are feasible and safe, potentially shortening length of stay and reducing ICU admissions.
Systematic Review
Does the use of wearable devices as part of CREWS systems improve postoperative monitoring and outcomes in adult patients undergoing major surgery?
Continuous postoperative monitoring with wearable devices is feasible, safe, and may reduce length of stay and ICU admissions by enabling early detection of clinical deterioration.
Postoperative deterioration is often preceded by abnormalities in vital parameters, but limited resources prevent their continuous monitoring in patients with no indication to ICU admission. The development of new technologies allowed the introduction of wearable devices (WDs), enabling the possibility of postoperative monitoring in surgical wards. We performed a Scoping Review to determine the current use of wearable devices as part of Continuous Remote Early Warning Score (CREWS) systems and their efficiency during postoperative period. This Scoping Review was conducted according to PRISMA-ScR guidelines. PICO framework was used before the search to define the review protocol. Systematic literature research has been performed on PubMed, MeSH, MEDLINE and Embase, considering a period between 2018 and February 2024. Prospective and retrospective studies involving patients undergoing cardiac and non-cardiac surgery are included. A total of 10 articles were included in the review. 11 different CE/FDA approved wearable devices were used in the studies analyzed. In all studies the WDs were applied the day of the surgery. The use of WDs as part of CREWS systems is feasible and safe. Furthermore, with the aid of other technologies (LoRa and Artificial Intelligence), they shorten Length of Stay (LOS) and reduce the number of ICU admissions with a reduction in healthcare costs. Continuous monitoring in surgical departments can facilitate the correct and timely identification of postoperative complications. This article is a starting point for the development of new protocols and for the application of these monitoring systems in clinical practice.
Bignami et al. (Tue,) conducted a systematic review in Postoperative monitoring. Wearable devices as part of Continuous Remote Early Warning Score (CREWS) systems vs. Standard intermittent monitoring / Early Warning Scores (EWS) was evaluated on Feasibility, safety, and efficiency of wearable devices during the postoperative period. Wearable devices used as part of Continuous Remote Early Warning Score systems in the postoperative period are feasible and safe, potentially shortening length of stay and reducing ICU admissions.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: