The value of vital sign trends in predicting and

monitoring clinical deterioration: A systematic review

A Journal Reading Presented to

Sandel Cose Sulapas, RN
Faculty, FNAHS BSN-Program
Davao Oriental State University

In Partial Fulfillment
of the requirements for
NCM 101
Health Assessment

By

Shaina O. Hanani
BSN-1C

Journal Reading#1/March 11, 2024

 The value of vital sign trends in predicting and
monitoring clinical deterioration: A systematic review

Idar Johan Brekke, Lars Håland Puntervoll,

Peter Bank Pedersen, John Kellett, Mikkel Brabrand

Summary

Vital signs such as temperature, blood pressure, pulse, oxygen saturation, and
respiration rate are considered to be crucial indicators to keep an eye on when a patient
is in the hospital. Vital sign changes before clinical deterioration are well-documented,
and prompt intervention depends on early identification of outcomes that could have
been avoided. To assess the potential of vital sign patterns to forecast clinical worsening
in patients hospitalized with acute illness, PubMed, Embase, Cochrane Library, and
CINAHL were searched in December 2017. Despite their importance in clinical practice,
the optimal ways to monitor and interpret them remain unknown. Research looking at
patterns in adult patients' vital signs that were periodically observed on hospital wards
as well as emergency rooms. Results that indicated a decline in clinical status were of
significance. carried out independently by two writers utilizing a prepared extraction
Just two of the 7,366 references that were checked could be included. These were
uncontrolled retrospective cohort studies. A study was conducted on 269,999
admissions to investigate the accuracy of various vital sign trend models by
discrete-time survival analysis. One looked at the trend in the weighted vital signs of the
Vitalpac Early Warning Score and included 44,53 medical admissions. They claimed that
patterns in vital signs made it easier to identify clinical deterioration. Crucial Evaluation
instruments were used throughout the appraisal process. The studies' modest bias risk
was a low level of evidential confidence. Furthermore, four research looking into early
warning trend scores that would not have otherwise been included were assessed This
review highlights the paucity of studies on trends in vital sign monitoring that occurs
periodically. The Several studies show a trend's increased usefulness despite being
erratic and imprecise examination. This emphasizes that well-controlled experiments
are necessary to fully evaluate the research query.
Personal Insights and Reflection

Vital signs are crucial markers of a person's physiological state and general health.
Usually, they consist of four main measurements:

Body temperature: This indicates how well the body is balancing the production and
loss of heat. The average human body temperature is approximately 98.6°F (37°C),
while minute changes may happen over the day. Unusual body temperature is linked
to the conditions of fever, hypothermia, and hyperthermia.

Heart rate or pulse rate: The heart's beats per minute (bpm) is measured by the pulse
rate. Adults normally have a resting heart rate between 60 and 100 bpm. Pulse rate
can be influenced by a number of factors, including general health, drugs, stress, and
physical exercise.

Breathing rate: This indicates how many breaths you take in a minute. Adults
normally breathe between 12 and 20 times each minute on average. Atypical
breathing rates may be a sign of lung conditions, metabolic issues, or respiratory
distress.

Blood Pressure: Blood pressure measures the force of blood against the walls of
arteries as the heart pumps it around the body. It consists of two numbers: systolic
pressure (the pressure when the heart contracts) and diastolic pressure (the pressure
when the heart relaxes). Normal blood pressure for adults is typically around 120/80
mmHg. Hypertension (high blood pressure) and hypotension (low blood pressure) can
both have serious health implications if not managed properly.

Vital sign monitoring is essential in a variety of contexts, such as hospitals,

emergency rooms, and even homes for people with certain medical issues. Vital sign
changes may be a symptom of infection, dehydration, underlying medical conditions,
or other anomalies that call for more testing and treatment.

Reference/s
https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0210875
&type=printable