Nearly 20% of hospitalized patients are released with unstable vital signs

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Close to one in five hospitalized patients are released from the hospital with vital sign instabilities, which can be linked to readmissions or death, according to a new study published in the Journal of General Internal Medicine.

For the study, researchers analyzed EMR data from 32,835 patients from six Dallas-Fort Worth area hospitals. The team searched for vital sign abnormalities in temperature, blood pressure, respiratory rate, heart rate and oxygen saturation. Analysis revealed that 18.7 percent of all patients were discharged with one or more vital sign instability.

Of the patients discharged with no abnormalities, 12.8 percent were readmitted or died within 30 days of discharged. The percentage of the patient population readmitted or dead within 30 days of discharge rose with the number of abnormal vital signs — 16.9 percent for one abnormality, 21.2 percent with two and 26 percent with three. Researchers also found that individuals with three or more abnormal vital signs were nearly four times as likely to die after being discharged.

"At a time when people are developing complicated, black box computerized algorithms to identify patients at high risk of readmission, our study highlights that the stability of vital signs, something doctors review with their own eyes every day, is a simple, clinically objective means of assessing readiness and safety for discharge," said the study's senior author Ethan Halm, MD, chief of the Division of Outcomes and Health Services Research in the Department of Clinical Sciences at UT Southwestern in Dallas. "There's a good reason we call them vital signs."

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