Authors: Trentino et al.
Journal: Anesthesia & Analgesia published: July 17, 2025
Summary:
This cost-effectiveness analysis evaluated whether remote continuous vital sign monitoring could reduce ICU use and hospital costs after scoliosis surgery. These patients often require postoperative monitoring in an ICU or high-dependency unit because of the complexity of surgery and concern for postoperative deterioration.
The authors studied implementation of a 24-hour remote continuous monitoring service called HIVE. This system allowed higher-risk postoperative patients to be monitored on general wards rather than routinely requiring ICU or high-dependency unit care.
The study compared scoliosis surgery patients before and after implementation of the HIVE service. There were 133 patients in the preimplementation group and 155 patients in the postimplementation group. The authors adjusted for differences in baseline patient characteristics.
After HIVE implementation, patients avoided an adjusted 27.1 hours in the ICU. Overall health care costs were reduced by AU$2,682, or about US$2,164, per patient compared with the preimplementation period.
Importantly, the reduction in ICU time and costs did not appear to come at the expense of worse outcomes. There were no statistically significant differences in hospital length of stay, emergency readmissions, or hospital-acquired complications.
Why this matters:
This study suggests that remote continuous vital sign monitoring may allow selected postoperative scoliosis surgery patients to be safely managed on general wards while reducing ICU utilization and overall health care costs. This is important because ICU beds are expensive, limited, and often needed for the sickest patients.
Take-home point:
For scoliosis surgery patients, a remote continuous monitoring service reduced ICU hours and overall inpatient costs without a significant increase in readmissions, complications, or length of stay.
Thank you to Anesthesia & Analgesia for publishing this article and allowing us to summarize it.