Timely recognition of the deteriorating inpatient remains challenging. Wearable monitoring systems (WMS) may augment current monitoring practices. However, there are many barriers to implementation in the hospital environment, and evidence describing the clinical impact of WMS on deterioration detection and patient outcome remains unclear. To assess the impact of vital-sign monitoring on detection of deterioration and related clinical outcomes in hospitalised patients using WMS, in comparison with standard care. A systematic search was conducted in August 2020 using MEDLINE, Embase, CINAHL, Cochrane Database of Systematic Reviews, CENTRAL, Health Technology Assessment databases and grey literature. Studies comparing the use of WMS against standard care for deterioration detection and related clinical outcomes in hospitalised patients were included. Deterioration related outcomes (primary) included unplanned intensive care admissions, rapid response team or cardiac arrest activation, total and major complications rate. Other clinical outcomes (secondary) included in-hospital mortality and hospital length of stay. Exploratory outcomes included alerting system parameters and clinical trial registry information. Of 8706 citations, 10 studies with different designs met the inclusion criteria, of which 7 were included in the meta-analyses. Overall study quality was moderate. The meta-analysis indicated that the WMS, when compared with standard care, was not associated with significant reductions in intensive care transfers (risk ratio, RR 0.87; 95% confidence interval, CI 0.66–1.15), rapid response or cardiac arrest team activation (RR 0.84; 95% CI 0.69–1.01), total (RR 0.77; 95% CI 0.44–1.32) and major (RR 0.55; 95% CI 0.24–1.30) complications prevalence. There was also no statistically significant association with reduced mortality (RR 0.48; 95% CI 0.18–1.29) and hospital length of stay (mean difference, MD − 0.09; 95% CI − 0.43 to 0.44). This systematic review indicates that there is no current evidence that implementation of WMS impacts early deterioration detection and associated clinical outcomes, as differing design/quality of available studies and diversity of outcome measures make it difficult to reach a definite conclusion. Our narrative findings suggested that alarms should be adjusted to minimise false alarms and promote rapid clinical action in response to deterioration. PROSPERO Registration number: CRD42020188633 .

中文翻译：

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可穿戴式连续生命体征监测对住院患者恶化检测和临床结果的影响：系统评价和荟萃分析

及时识别病情恶化的住院患者仍然具有挑战性。可穿戴监控系统 (WMS) 可以增强当前的监控实践。然而，在医院环境中实施存在许多障碍，描述 WMS 对恶化检测和患者结果的临床影响的证据仍不清楚。与标准护理相比，评估生命体征监测对使用 WMS 的住院患者的恶化检测和相关临床结果的影响。2020 年 8 月使用 MEDLINE、Embase、CINAHL、Cochrane 系统评价数据库、CENTRAL、卫生技术评估数据库和灰色文献进行了系统搜索。研究将 WMS 的使用与标准护理进行比较，以检测住院患者的恶化检测和相关临床结果。恶化相关结果（主要）包括意外重症监护入院、快速反应小组或心脏骤停激活、总和主要并发症发生率。其他临床结果（次要）包括院内死亡率和住院时间。探索性结果包括警报​​系统参数和临床试验注册信息。在 8706 篇引文中，10 篇不同设计的研究符合纳入标准，其中 7 篇被纳入荟萃分析。总体研究质量中等。荟萃分析表明，与标准护理相比，WMS 与重症监护转移（风险比，RR 0.87；95% 置信区间，CI 0.66-1.15）、快速反应或心脏骤停团队激活的显着减少无关（RR 0.84；95% CI 0.69–1.01），总计（RR 0.77；95% CI 0.44–1。32) 和主要 (RR 0.55; 95% CI 0.24–1.30) 并发症发生率。死亡率（RR 0.48；95% CI 0.18–1.29）和住院时间（平均差，MD - 0.09；95% CI - 0.43 - 0.44）也没有统计学上的显着关联。该系统评价表明，目前没有证据表明 WMS 的实施会影响早期恶化检测和相关的临床结果，因为现有研究的不同设计/质量和结果测量的多样性使得难以得出明确的结论。我们的叙述性研究结果表明，应调整警报以最大程度地减少误报并促进针对恶化的快速临床行动。PROSPERO 注册号：CRD42020188633。死亡率（RR 0.48；95% CI 0.18–1.29）和住院时间（平均差，MD - 0.09；95% CI - 0.43 - 0.44）也没有统计学上的显着关联。该系统评价表明，目前没有证据表明 WMS 的实施会影响早期恶化检测和相关的临床结果，因为现有研究的不同设计/质量和结果测量的多样性使得难以得出明确的结论。我们的叙述性研究结果表明，应调整警报以最大程度地减少误报并促进针对恶化的快速临床行动。PROSPERO 注册号：CRD42020188633。死亡率（RR 0.48；95% CI 0.18–1.29）和住院时间（平均差，MD - 0.09；95% CI - 0.43 - 0.44）也没有统计学上的显着关联。该系统评价表明，目前没有证据表明 WMS 的实施会影响早期恶化检测和相关的临床结果，因为现有研究的不同设计/质量和结果测量的多样性使得难以得出明确的结论。我们的叙述性研究结果表明，应调整警报以最大程度地减少误报并促进针对恶化的快速临床行动。PROSPERO 注册号：CRD42020188633。该系统评价表明，目前没有证据表明 WMS 的实施会影响早期恶化检测和相关的临床结果，因为现有研究的不同设计/质量和结果测量的多样性使得难以得出明确的结论。我们的叙述性研究结果表明，应调整警报以最大程度地减少误报并促进针对恶化的快速临床行动。PROSPERO 注册号：CRD42020188633。该系统评价表明，目前没有证据表明 WMS 的实施会影响早期恶化检测和相关的临床结果，因为现有研究的不同设计/质量和结果测量的多样性使得难以得出明确的结论。我们的叙述性研究结果表明，应调整警报以最大程度地减少误报并促进针对恶化的快速临床行动。PROSPERO 注册号：CRD42020188633。我们的叙述性研究结果表明，应调整警报以最大程度地减少误报并促进针对恶化的快速临床行动。PROSPERO 注册号：CRD42020188633。我们的叙述性研究结果表明，应调整警报以最大程度地减少误报并促进针对恶化的快速临床行动。PROSPERO 注册号：CRD42020188633。