title: Home monitoring of heart failure patients at risk for hospital readmission using a novel under-the-mattress piezoelectric sensor: A preliminary single centre experience.
abstract: Introduction A piezoelectric sensor (PS) converts mechanical deformations into electrical signals. We used a contactless under-the-mattress PS to monitor physiological vibrations resulting from breathing, pumping of the heart, and body movements, among individuals at home following hospitalization for heart failure (HF). Our objectives were to assess acceptability of the device in the home, to assess physiological patterns, and to determine if altered patterns correlate with readmission. Methods We conducted a prospective observational study of 30 patients discharged home following HF hospitalization. PS data included a continuous nightly assessment of heart rate, respiration rate, movement rate, rapid and shallow respiration duration, and a behaviour score. We utilized random forest classification to classify average nightly data by readmission status. Results We collected 640 nights of PS data from 29 patients. There were nine readmissions, of which four were for HF. PS monitoring was tolerated by all but one of the participants. We inspected continuous nightly physiological profiles and noted differences between patients who were and were not readmitted. Patients readmitted for HF had higher average heart and respiration rates, and more respiration variability. Average nightly respiratory rate was most predictive of readmission. Discussion We are the first to study nocturnal physiological patterns of HF patients at home using a contactless under-the-mattress monitoring system. We noted patterns that may be unique to patients at risk for readmission due to HF. Respiratory rate was the most important risk-adjusted associate of readmission for HF. Further studies should investigate the efficacy of home PS monitoring in HF populations.
authors.affiliation: 1 Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota.
authors.forename: Mosi K
authors.initials: MK
authors.lastname: Bennett
authors.affiliation: 2 Department of Quantitative Methods, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Mingyuan
authors.initials: M
authors.lastname: Shao
authors.affiliation: 3 Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.|4 Center for Connected Care, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Eiran Z
authors.initials: EZ
authors.lastname: Gorodeski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D009068:Movement / Q000502:physiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011446:Prospective Studies; D056152:Respiratory Rate / Q000502:physiology; D012890:Sleep; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*
keywords: Remote monitoring; heart failure; home monitoring; readmissions