A RANDOMIZED TRIAL OF CONTINUOUS REMOTE PATIENT MONITORING FOR VITAL SIGNS AFTER MAJOR ABDOMINAL SURGERY
Keywords:
Abdominal Surgery, Critical Care, Monitoring, Physiologic, Postoperative Complications, Randomized Controlled Trial, Remote Sensing Technology, Vital SignsAbstract
Background: Patients recovering from major abdominal surgery remain vulnerable to rapid clinical deterioration, yet ward-based monitoring typically relies on intermittent vital-sign measurements that may delay recognition of instability. Continuous remote monitoring has emerged as a potential method to enhance early detection, though evidence from randomized trials in high-risk surgical populations remains limited.
Objective: To evaluate whether continuous real-time vital-sign monitoring reduces unplanned ICU transfers and serious postoperative complications compared with standard intermittent monitoring.
Methods: A randomized controlled trial was conducted over six months in a tertiary care surgical unit. A total of 120 adults undergoing major abdominal procedures were enrolled and randomized equally to continuous wireless monitoring or standard ward monitoring. The intervention group received real-time monitoring of heart rate, respiratory rate, oxygen saturation, and skin temperature with automated alerts. Primary and secondary outcomes included unplanned ICU transfers, serious complications, rapid response team activations, time to recognition of deterioration, and length of hospital stay. Data were analyzed using intention-to-treat principles, employing t-tests for continuous normally distributed variables and chi-square tests for categorical outcomes.
Results: Unplanned ICU transfers occurred in 8% of the monitored group compared with 17% of controls. Serious complications were documented in 14% versus 23% respectively. Rapid response team activations were lower in the intervention arm (22 vs. 31), and median time to recognition of deterioration was shorter (28 vs. 56 minutes). Length of stay was reduced by approximately one day among monitored patients.
Conclusion: Continuous remote vital-sign monitoring improved early detection of instability and was associated with fewer ICU transfers and complications. These findings support the potential integration of real-time monitoring technologies into routine postoperative care.
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Copyright (c) 2025 Muhammad Salman Riaz (Author)
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