A wearable patch based remote early warning score (REWS) in major abdominal cancer surgery patients

Jonna A van der Stam*, Eveline H J Mestrom, Simon W Nienhuijs, Ignace H J T de Hingh, Arjen-Kars Boer, Natal A W van Riel, Koen T J de Groot, Wim Verhaegh, Volkher Scharnhorst, R Arthur Bouwman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


INTRODUCTION: The shift toward remote patient monitoring methods to detect clinical deterioration requires testing of wearable devices in real-life clinical settings. This study aimed to develop a remote early warning scoring (REWS) system based on continuous measurements using a wearable device, and compare its diagnostic performance for the detection of deterioration to the diagnostic performance of the conventional modified early warning score (MEWS).

MATERIALS AND METHODS: The study population of this prospective, single center trial consisted of patients who underwent major abdominal cancer surgery and were monitored using routine in-hospital spotcheck measurements of the vital parameters. Heart and respiratory rates were measured continuously using a wireless accelerometer patch (HealthDot). The prediction by MEWS of deterioration toward a complication graded Clavien-Dindo of 2 or higher was compared to the REWS derived from continuous measurements by the wearable patch.

MAIN RESULTS: A total of 103 patients and 1909 spot-check measurements were included in the analysis. Postoperative deterioration was observed in 29 patients. For both EWS systems, the sensitivity (MEWS: 0.20 95% CI: [0.13-0.29], REWS: 0.20 95% CI: [0.13-0.29]) and specificity (MEWS: 0.96 95% CI: [0.95-0.97], REWS: 0.96 95% CI: [0.95-0.97]) were assessed.

CONCLUSIONS: The diagnostic value of the REWS method, based on continuous measurements of the heart and respiratory rates, is comparable to that of the MEWS in patients following major abdominal cancer surgery. The wearable patch could detect the same amount of deteriorations, without requiring manual spot check measurements.

Original languageEnglish
Pages (from-to)278-284
Number of pages7
JournalEuropean Journal of Surgical Oncology
Issue number1
Early online date2 Sept 2022
Publication statusPublished - Jan 2023


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