Real-time Evaluation and Continuous Observation of Vital Signs for Enhanced Recovery

The RECOVER study evaluates the use of continuous wearable monitoring in surgical ward for the early detection of postoperative complications in patients recovering after major surgery. The study begins with the evaluation of urologic surgery. It focuses on whether continuous measurement of vital signs in the surgical ward can identify clinical deterioration and postoperative complications earlier than routine postoperative surveillance alone: postoperative complications are often preceded by changes in vital signs and may develop during the first days after surgery, when patients are usually monitored intermittently in the ward. Continuous wireless monitoring is intended to provide earlier recognition of respiratory and hemodynamic deterioration while patients recover outside the operating room and outside intensive care.

The main objective is to assess whether continuous monitoring of vital signs can detect early signs of medical or surgical postoperative complications after moderate-to-high complexity urologic surgery performed under general anesthesia. The protocol is particularly focused on identifying episodes of desaturation, tachypnea, hemodynamic instability, and persistent deviation of vital signs from patient's baseline values during the postoperative period.

Patient enrollment takes place in the Urology ward before the scheduled operation. During the preoperative anesthesiology evaluation, the anesthesiologist provides study information and asks the patient to participate by signing informed consent and personal data processing forms. This enrollment process is maintained in both patient pathways described in the protocol.

For patients managed with continuous monitoring, the wearable system is applied on the evening before surgery so that baseline vital sign values can be collected under resting conditions. Monitoring is interrupted before transfer to the operating room and restarted after the patient returns from surgery to the ward. The patient then wears the system for at least 72 hours after surgery, and the device does not replace standard postoperative monitoring.

The wearable platform used in the protocol is the Portrait Mobile® system by GE HealthCare. It continuously records respiratory rate, oxygen saturation, and heart rate, while blood pressure and EKG continues to be measured intermittently according to usual ward practice in order to maintain the non-intensive care settings and the actual patient-nurse ratio. Data are transmitted through the hospital Wi-Fi network to a dedicated monitoring infrastructure, where alarms can be visualized on the ward monitoring station.