Counterintuitively, the risk associated with the post-operative period is extremely high in comparison to all other stages of a surgical procedure. When patients having a major surgery safely reach the post-anesthesia care unit, it is assumed that they have survived the most dangerous part of the perioperative experience. However, significant risk is presented in the post-operative period. Mortality rate in the 30 days after surgery is orders of magnitude higher than intraoperative mortality1,2. In fact, if the month after surgery was considered a distinct disease, it would be the third leading cause of death in the United States3. The numbers are rather grave: about 2% of U.S. surgical inpatients, age 45 years or more, die within 30 days of the surgical procedure4. Most postoperative mortality occurs during the initial hospitalization period, while patients are under full medical care.
Thirty-day all-cause mortality is largely related to cardiovascular complications, particularly myocardial infarctions (MI)5,6,. About 12% of surgical inpatients more than 45 years of age have an infarction, usually within the initial 3 postoperative days7. Patients who survived MI will stay in hospital longer, suffer long term adverse effects and reduced life expectancy.
Life-threatening complications are usually preceded by abnormalities in vital signs that occur minutes to hours earlier8. Vital signs are usually obtained in regular wards at 4-6-hour intervals. In a clinician and patient-blinded prospective observational cohort, it was recently shown that ward hypotension is common, profound, and prolonged – and nearly always missed9. Identification of even subtle changes in basic vital signs will allow clinicians to detect deterioration well before serious adverse events occur. Consequent clinical interventions will in turn prevent complications, or at least moderate their severity.
There is no technology today that allows frequent monitoring of blood pressure in a manner that is well-tolerated by patients and is low cost.
Sensifree’s affordable, patient-friendly, and easy to use method for non-invasive continuous BP (cNIBP) monitoring, offers a great value in the treatment of postoperative patients, as they go through the various stages of their admission and recovery. Our roadmap includes adding additional vital signs to provide the care team a fuller picture of the patient’s condition. These will include SpO2, respiration rate and heart rate.