Key result
Automated monitoring reveals noncardiac surgery patients spend 6% of recovery time with abnormal vital signs.
Why the study?
In patients recovering from noncardiac surgery on general wards, the duration and severity of postoperative vital sign abnormalities remain largely unknown.
What is the duration and severity of postoperative vital sign abnormalities in adults recovering from noncardiac surgery on general wards?
Observational (n=190)
Blinded
No
What is the duration and severity of postoperative vital sign abnormalities in adults recovering from noncardiac surgery on general wards?
Automated continuous monitoring reveals that abnormal vital signs, particularly hypoxaemia and bradypnoea, are common in patients recovering from noncardiac surgery on general wards.
Minority monitoring time with abnormal vital signs should not yet change practice; leaves open whether this burden predicts deterioration in randomized studies.
BACKGROUND: In patients recovering from noncardiac surgery on general wards, the duration and severity of postoperative vital sign abnormalities remain largely unknown. OBJECTIVES: To quantify abnormal vital signs using automated continuous monitoring. DESIGN: Single-centre prospective observational study. SETTING: University Medical Center Hamburg-Eppendorf, Hamburg, Germany. PATIENTS: A total of 190 adults recovering from noncardiac surgery on general wards. INTERVENTION: Automated blinded monitoring of vital signs using a wearable device for up to 5 postoperative days. MAIN OUTCOME MEASURES: The primary outcome was the percentage of monitoring time patients had any abnormal vital sign (peripheral oxygen saturation ≤91%, respiratory rate ≤8 or ≥25 breaths per min, systolic blood pressure ≤90 or ≥220 mmHg, or pulse rate ≤40 or ≥131 beats per min). RESULTS: The median [IQR] percentage of monitoring time and the median cumulative time patients had any abnormal vital sign were 6 [3 to 12]% and 155 [58 to 375] min, respectively. 74 patients (39%) had any abnormal vital sign for at least 15 continuous minutes. The most frequently observed vital sign abnormalities were hypoxaemia and bradypnoea. Hypoxaemia occurred for a median cumulative time of 33 [7 to 123] min and lasted for at least 15 continuous minutes in 59 patients (31%). Bradypnoea occurred for a median cumulative time of 62 [17 to 159] min and lasted for at least 15 continuous minutes in 19 patients (10%). Other vital sign abnormalities were rare. CONCLUSIONS: Abnormal vital signs were common in patients recovering from noncardiac surgery on general wards. Hypoxaemia and bradypnoea were the most common vital sign abnormalities. Future research should further investigate the clinical relevance of abnormal vital signs and evaluate whether automated vital sign monitoring can facilitate early detection and timely intervention to improve patient outcomes. STUDY REGISTRATION: German Clinical Trials Register (DRKS00030284) on 6 October 2022.
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Flick et al. (2026) conducted an observational in Recovering from noncardiac surgery (n=190). Automated continuous monitoring using a wearable device was evaluated on Percentage of monitoring time patients had any abnormal vital sign. Automated continuous monitoring revealed that patients recovering from noncardiac surgery spent a median of 6% of monitoring time with abnormal vital signs, most commonly hypoxaemia and bradypnoea.
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