Continuously monitored vital signs for detection of myocardial injury in high-risk patients – An observational study

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Standard

Continuously monitored vital signs for detection of myocardial injury in high-risk patients – An observational study. / Loft, Frederik C.; Rasmussen, Søren M.; Elvekjaer, Mikkel; Haahr-Raunkjaer, Camilla; Sørensen, Helge B. D.; Aasvang, Eske K.; Meyhoff, Christian S.; WARD-Project Group.

In: Acta Anaesthesiologica Scandinavica, Vol. 66, No. 6, 2022, p. 674-683.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Loft, FC, Rasmussen, SM, Elvekjaer, M, Haahr-Raunkjaer, C, Sørensen, HBD, Aasvang, EK, Meyhoff, CS & WARD-Project Group 2022, 'Continuously monitored vital signs for detection of myocardial injury in high-risk patients – An observational study', Acta Anaesthesiologica Scandinavica, vol. 66, no. 6, pp. 674-683. https://doi.org/10.1111/aas.14056

APA

Loft, F. C., Rasmussen, S. M., Elvekjaer, M., Haahr-Raunkjaer, C., Sørensen, H. B. D., Aasvang, E. K., Meyhoff, C. S., & WARD-Project Group (2022). Continuously monitored vital signs for detection of myocardial injury in high-risk patients – An observational study. Acta Anaesthesiologica Scandinavica, 66(6), 674-683. https://doi.org/10.1111/aas.14056

Vancouver

Loft FC, Rasmussen SM, Elvekjaer M, Haahr-Raunkjaer C, Sørensen HBD, Aasvang EK et al. Continuously monitored vital signs for detection of myocardial injury in high-risk patients – An observational study. Acta Anaesthesiologica Scandinavica. 2022;66(6):674-683. https://doi.org/10.1111/aas.14056

Author

Loft, Frederik C. ; Rasmussen, Søren M. ; Elvekjaer, Mikkel ; Haahr-Raunkjaer, Camilla ; Sørensen, Helge B. D. ; Aasvang, Eske K. ; Meyhoff, Christian S. ; WARD-Project Group. / Continuously monitored vital signs for detection of myocardial injury in high-risk patients – An observational study. In: Acta Anaesthesiologica Scandinavica. 2022 ; Vol. 66, No. 6. pp. 674-683.

Bibtex

@article{fe0f9dc0512b4c808e4ae53f69e22d96,
title = "Continuously monitored vital signs for detection of myocardial injury in high-risk patients – An observational study",
abstract = "Background: Patients are at risk of myocardial injury after major non-cardiac surgery and during acute illness. Myocardial injury is associated with mortality, but often asymptomatic and currently detected through intermittent cardiac biomarker screening. This delays diagnosis, where vital signs deviations may serve as a proxy for early signs of myocardial injury. This study aimed to assess the association between continuous monitored vital sign deviations and subsequent myocardial injury following major abdominal cancer surgery and during acute exacerbation of chronic obstructive pulmonary disease. Methods: Patients undergoing major abdominal cancer surgery or admitted with acute exacerbation of chronic obstructive pulmonary disease had daily troponin measurements. Continuous wireless monitoring of several vital signs was performed for up to 96 h after admission or surgery. The primary exposure was cumulative duration of peripheral oxygen saturation (SpO2) below 85% in the 24 h before the primary outcome of myocardial injury, defined as a new onset ischaemic troponin elevation assessed daily. If no myocardial injury occurred, the primary exposure was based on the first 24 h of measurement. Results: A total of 662 patients were continuously monitored and 113 (17%) had a myocardial injury. Cumulative duration of SpO2 < 85% was significantly associated with myocardial injury (mean difference 14.2 min [95% confidence interval −4.7 to 33.1 min]; p =.005). Durations of hypoxaemia (SpO2 < 88% and SpO2 < 80%), tachycardia (HR > 110 bpm and HR > 130 bpm) and tachypnoea (RR > 24 min−1 and RR > 30 min−1) were also significantly associated with myocardial injury (p <.04, for all). Conclusion: Duration of severely low SpO2 detected by continuous wireless monitoring is significantly associated with myocardial injury in high-risk patients admitted to hospital wards. The effect of early detection and interventions should be assessed next.",
keywords = "acute exacerbation of chronic obstructive pulmonary disease, continuously monitoring, hypoxaemia, myocardial injury, noncardiac surgery, tachycardia, tachypnoea, vital signs",
author = "Loft, {Frederik C.} and Rasmussen, {S{\o}ren M.} and Mikkel Elvekjaer and Camilla Haahr-Raunkjaer and S{\o}rensen, {Helge B. D.} and Aasvang, {Eske K.} and Meyhoff, {Christian S.} and {WARD-Project Group}",
note = "Publisher Copyright: {\textcopyright} 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.",
year = "2022",
doi = "10.1111/aas.14056",
language = "English",
volume = "66",
pages = "674--683",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell",
number = "6",

}

RIS

TY - JOUR

T1 - Continuously monitored vital signs for detection of myocardial injury in high-risk patients – An observational study

AU - Loft, Frederik C.

AU - Rasmussen, Søren M.

AU - Elvekjaer, Mikkel

AU - Haahr-Raunkjaer, Camilla

AU - Sørensen, Helge B. D.

AU - Aasvang, Eske K.

AU - Meyhoff, Christian S.

AU - WARD-Project Group

N1 - Publisher Copyright: © 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

PY - 2022

Y1 - 2022

N2 - Background: Patients are at risk of myocardial injury after major non-cardiac surgery and during acute illness. Myocardial injury is associated with mortality, but often asymptomatic and currently detected through intermittent cardiac biomarker screening. This delays diagnosis, where vital signs deviations may serve as a proxy for early signs of myocardial injury. This study aimed to assess the association between continuous monitored vital sign deviations and subsequent myocardial injury following major abdominal cancer surgery and during acute exacerbation of chronic obstructive pulmonary disease. Methods: Patients undergoing major abdominal cancer surgery or admitted with acute exacerbation of chronic obstructive pulmonary disease had daily troponin measurements. Continuous wireless monitoring of several vital signs was performed for up to 96 h after admission or surgery. The primary exposure was cumulative duration of peripheral oxygen saturation (SpO2) below 85% in the 24 h before the primary outcome of myocardial injury, defined as a new onset ischaemic troponin elevation assessed daily. If no myocardial injury occurred, the primary exposure was based on the first 24 h of measurement. Results: A total of 662 patients were continuously monitored and 113 (17%) had a myocardial injury. Cumulative duration of SpO2 < 85% was significantly associated with myocardial injury (mean difference 14.2 min [95% confidence interval −4.7 to 33.1 min]; p =.005). Durations of hypoxaemia (SpO2 < 88% and SpO2 < 80%), tachycardia (HR > 110 bpm and HR > 130 bpm) and tachypnoea (RR > 24 min−1 and RR > 30 min−1) were also significantly associated with myocardial injury (p <.04, for all). Conclusion: Duration of severely low SpO2 detected by continuous wireless monitoring is significantly associated with myocardial injury in high-risk patients admitted to hospital wards. The effect of early detection and interventions should be assessed next.

AB - Background: Patients are at risk of myocardial injury after major non-cardiac surgery and during acute illness. Myocardial injury is associated with mortality, but often asymptomatic and currently detected through intermittent cardiac biomarker screening. This delays diagnosis, where vital signs deviations may serve as a proxy for early signs of myocardial injury. This study aimed to assess the association between continuous monitored vital sign deviations and subsequent myocardial injury following major abdominal cancer surgery and during acute exacerbation of chronic obstructive pulmonary disease. Methods: Patients undergoing major abdominal cancer surgery or admitted with acute exacerbation of chronic obstructive pulmonary disease had daily troponin measurements. Continuous wireless monitoring of several vital signs was performed for up to 96 h after admission or surgery. The primary exposure was cumulative duration of peripheral oxygen saturation (SpO2) below 85% in the 24 h before the primary outcome of myocardial injury, defined as a new onset ischaemic troponin elevation assessed daily. If no myocardial injury occurred, the primary exposure was based on the first 24 h of measurement. Results: A total of 662 patients were continuously monitored and 113 (17%) had a myocardial injury. Cumulative duration of SpO2 < 85% was significantly associated with myocardial injury (mean difference 14.2 min [95% confidence interval −4.7 to 33.1 min]; p =.005). Durations of hypoxaemia (SpO2 < 88% and SpO2 < 80%), tachycardia (HR > 110 bpm and HR > 130 bpm) and tachypnoea (RR > 24 min−1 and RR > 30 min−1) were also significantly associated with myocardial injury (p <.04, for all). Conclusion: Duration of severely low SpO2 detected by continuous wireless monitoring is significantly associated with myocardial injury in high-risk patients admitted to hospital wards. The effect of early detection and interventions should be assessed next.

KW - acute exacerbation of chronic obstructive pulmonary disease

KW - continuously monitoring

KW - hypoxaemia

KW - myocardial injury

KW - noncardiac surgery

KW - tachycardia

KW - tachypnoea

KW - vital signs

U2 - 10.1111/aas.14056

DO - 10.1111/aas.14056

M3 - Journal article

C2 - 35247272

AN - SCOPUS:85133602914

VL - 66

SP - 674

EP - 683

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 6

ER -

ID: 325374940