Evidence map›Paper›PMID 41856853›Full record

Observational studyJoint Commission journal on quality and patient safety2026

Association of Vital Sign and Laboratory Abnormalities Detected via Remote Monitoring with ICU Readmission and Mortality: An Observational Cohort Study.

Neil E Rens, Johanna J Rajotte, Hao Deng, Jiawei Meng, Ariel L Mueller, Timothy T Houle, Jeanine P Wiener-Kronish, Kyan C Safavi, Katarina J Ruscic

Abstract readObservational Study
In one paragraph

Observational study in Joint Commission journal on quality and patient safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Neil E Rens
Johanna J Rajotte
Hao Deng
Jiawei Meng
Ariel L Mueller
Timothy T Houle
Jeanine P Wiener-Kronish
Kyan C Safavi
Katarina J Ruscic

Funding

Research Training for AnesthetistsT32GM007592 · NIGMS · MASSACHUSETTS GENERAL HOSPITAL · PI STUART A FORMAN · 1985 to 2026
$11.8M
The Impact of Anesthetics on Lymphatic Vessel Contractility and Extracellular Fluid UptakeK08GM155886 · NIGMS · MASSACHUSETTS GENERAL HOSPITAL · PI Katarina J Ruscic · 2024 to 2026
$394k
NIGMS NIH HHS K08 GM155886NIGMS NIH HHS T32 GM007592
6 · The paper itself

Abstract

backgroundPost-intensive care unit (ICU) patients remain at high risk for adverse outcomes, and early identification of instability may improve outcomes and reduce costs. This study measures the association between eight vital sign and laboratory abnormalities ("flags") on surgical wards and the odds of ICU readmission or death in surgical patients after ICU transfer. Flags captured intuitive indications for ICU admission, including tachycardia, hypotension, hypoxemia, hyperkalemia, hyperglycemia, hypoglycemia, and anemia, which may be missed with infrequent ward evaluation.

methodsThis single-center, observational cohort study included all adult surgical patients transferred from the ICU to a general care ward between May 2017 and March 2019 pre-COVID-19 pandemic. A mixed effects model evaluated the relationship between virtual flags and adverse discharge within six hours, adjusted for demographics and confounders. Modeling was inferential and not intended for diagnostic or screening prediction.

resultsA total of 391 surgical ICU admissions were enrolled, comprising 138,623 rolling one-hour observation windows. After ICU discharge, 73 (18.7%) transfers died or were readmitted to the ICU. A flag on the wards was associated with 11.44-fold increased odds of ICU readmission or death within six hours of the flag (95% CI: 7.49-17.49) and 3.36-fold increased odds within 48 hours (95% CI: 2.23-5.05). A tachycardia flag raised the odds by 25.25 (95% CI: 13.34-47.82). Flags occurred on average every 2.6 hours per hundred ward patients monitored.

conclusionsThe presence of eight actionable vital sign and laboratory abnormalities which were detected in an automated system was strongly associated with ICU readmission or death after ICU transfer. Incorporating such monitoring on surgical wards could enable timely interventions, improve patient safety, and reduce mortality without alarm fatigue.

Indexed as

Hospital MortalityIntensive Care UnitsPatient ReadmissionRemote Patient MonitoringVital SignsAgedCohort StudiesFemaleHumansMaleMiddle Agedalarm fatiguecritical carefailure to rescueICU readmissioninpatient death, patient safety, automated monitoring, early warning systemremote monitoring

Identifiers

PMID41856853
PMCPMC13289044

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.