AUTHOR=Eisenkraft Arik , Goldstein Nir , Merin Roei , Fons Meir , Ishay Arik Ben , Nachman Dean , Gepner Yftach 

TITLE=Developing a real-time detection tool and an early warning score using a continuous wearable multi-parameter monitor

JOURNAL=Frontiers in Physiology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1138647

DOI=10.3389/fphys.2023.1138647

ISSN=1664-042X

ABSTRACT=<p><bold>Background:</bold> Currently-used tools for early recognition of clinical deterioration have high sensitivity, but with low specificity and are based on infrequent measurements. We aimed to develop a pre-symptomatic and real-time detection and warning tool for potential patients’ deterioration based on multi-parameter real-time warning score (MPRT-WS).</p><p><bold>Methods:</bold> A total of more than 2 million measurements were collected, pooled, and analyzed from 521 participants, of which 361 were patients in general wards defined at high-risk for deterioration and 160 were healthy participants allocation as controls. The risk score stratification was based on cutoffs of multiple physiological parameters predefined by a panel of specialists, and included heart rate, blood oxygen saturation (SpO<sub>2</sub>), respiratory rate, cuffless systolic and diastolic blood pressure (SBP and DBP), body temperature, stroke volume (SV), cardiac output, and systemic vascular resistance (SVR), recorded every 5 min for a period of up to 72 h. The data was used to define the various risk levels of a real-time detection and warning tool, comparing it with the clinically-used National Early Warning Score (NEWS).</p><p><bold>Results:</bold> When comparing risk levels among patients using both tools, 92.6%, 6.1%, and 1.3% of the readings were defined as “Low”, “Medium”, and “High” risk with NEWS, and 92.9%, 6.4%, and 0.7%, respectively, with MPRT-WS (<italic>p</italic> = 0.863 between tools). Among the 39 patients that deteriorated, 30 patients received ‘High’ or ‘Urgent’ using the MPRT-WS (42.7 ± 49.1 h before they deteriorated), and only 6 received ‘High’ score using the NEWS. The main abnormal vitals for the MPRT-WS were SpO<sub>2</sub>, SBP, and SV for the “Urgent” risk level, DBP, SVR, and SBP for the “High” risk level, and DBP, SpO<sub>2</sub>, and SVR for the “Medium” risk level.</p><p><bold>Conclusion:</bold> As the new detection and warning tool is based on highly-frequent monitoring capabilities, it provides medical teams with timely alerts of pre-symptomatic and real-time deterioration.</p>