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Review
. 2023 Nov 30;12(23):7430.
doi: 10.3390/jcm12237430.

Predicting Cardiopulmonary Arrest with Digital Biomarkers: A Systematic Review

Gioacchino D De Sario Velasquez  1 , Antonio J Forte  1 , Christopher J McLeod  2 , Charles J Bruce  2 , Laura M Pacheco-Spann  3 , Karla C Maita  1 , Francisco R Avila  1 , Ricardo A Torres-Guzman  1 , John P Garcia  1 , Sahar Borna  1 , Christopher L Felton  4 , Rickey E Carter  3 , Clifton R Haider  4
Affiliations
Review

Predicting Cardiopulmonary Arrest with Digital Biomarkers: A Systematic Review

Gioacchino D De Sario Velasquez et al. J Clin Med. .

Abstract

(1) Background: Telemetry units allow the continuous monitoring of vital signs and ECG of patients. Such physiological indicators work as the digital signatures and biomarkers of disease that can aid in detecting abnormalities that appear before cardiac arrests (CAs). This review aims to identify the vital sign abnormalities measured by telemetry systems that most accurately predict CAs. (2) Methods: We conducted a systematic review using PubMed, Embase, Web of Science, and MEDLINE to search studies evaluating telemetry-detected vital signs that preceded in-hospital CAs (IHCAs). (3) Results and Discussion: Out of 45 studies, 9 met the eligibility criteria. Seven studies were case series, and 2 were case controls. Four studies evaluated ECG parameters, and 5 evaluated other physiological indicators such as blood pressure, heart rate, respiratory rate, oxygen saturation, and temperature. Vital sign changes were highly frequent among participants and reached statistical significance compared to control subjects. There was no single vital sign change pattern found in all patients. ECG alarm thresholds may be adjustable to reduce alarm fatigue. Our review was limited by the significant dissimilarities of the studies on methodology and objectives. (4) Conclusions: Evidence confirms that changes in vital signs have the potential for predicting IHCAs. There is no consensus on how to best analyze these digital biomarkers. More rigorous and larger-scale prospective studies are needed to determine the predictive value of telemetry-detected vital signs for IHCAs.

Keywords: cardiac arrest; electrocardiogram; in-hospital cardiac arrest; physiological marker; physiological monitoring; telemetry; vital signs.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study selection process: Process of study selection following the PRISMA 2020 flow diagram for systematic reviews.
Figure 2
Figure 2
Risk of bias graph: Review authors’ judgments about each risk of bias item presented as percentages across all included studies.
Figure 3
Figure 3
Risk of bias summary: Review authors’ judgments about each included article’s risk of bias in the different components of the analysis. Red stands for high risk of bias, yellow stands for unclear risk, and green stands for low risk [29,30,31,32,33,34,35,36,37].
Figure 4
Figure 4
Monitoring digital biomarkers to predict cardiac arrest. This image depicts the use of telemetry to monitor and capture vital sign changes preceding cardiac arrests. Alarms trigger rapid response systems to intervene in a timely manner. Created with BioRender.com.
See this image and copyright information in PMC

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