The optimal duration of continuous respiratory rate monitoring to predict in-hospital mortality within seven days of admission – A pilot study in a low resource setting
Background: Currently there are no established benefits from the continuous monitoring of vital signs, and the optimal time period for respiratory rate measurement is unknown. Setting: Low resource Ugandan hospital, Methods: Prospective observational study. Respiratory rates of acutely ill patients...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424002194 |
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| Summary: | Background: Currently there are no established benefits from the continuous monitoring of vital signs, and the optimal time period for respiratory rate measurement is unknown. Setting: Low resource Ugandan hospital, Methods: Prospective observational study. Respiratory rates of acutely ill patients were continuously measured by a piezoelectric device for up to seven hours after admission to hospital. Results: 22 (5.5%) out of 402 patients died within 7 days of hospital admission. The highest c-statistic of discrimination for 7-day mortality (0.737 SE 0.078) was obtained after four hours of continuously measured respiratory rates transformed into a weighted respiratory rate score (wRRS). After seven hours of measurement the c-statistic of the wRRS fell to 0.535 SE 0.078. 20% the patients who died within seven days did not have an elevated National Early Warning Score (NEWS) on admission but were identified by the 4-hour wRRS. None of the 88 patients whose average respiratory rate remained between 12 and 20 bpm throughout four hours of observation died within 7 days of admission. A simple predictive model that included the four-hour wRRS, Shock Index and altered mental status had a c-statistic for 7-day in-hospital mortality of 0.843 SE. 0.057. Conclusion: Four hours of continuously measured respiratory rates was the observation period that best predicted 7-day in-hospital mortality. After four hours the discrimination of a weighted respiratory rate score deteriorated rapidly. |
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| ISSN: | 2666-5204 |