Presenting Author:

Principal Investigator:

Department:

Neurology, Ken and Ruth Davee Department

Keywords:

Actiwatch, Actigraphy, Arousal, Activity, Mobility, Critical, patients, ICU, neurological, assessments, early mobilizati... [Read full text] Actiwatch, Actigraphy, Arousal, Activity, Mobility, Critical, patients, ICU, neurological, assessments, early mobilization, minimizing sedation. [Shorten text]

Location:

Ryan Family Atrium, Robert H. Lurie Medical Research Center

C58 - Clinical Women's Health Research

Evaluating the utility of actiwatches in critically ill patients

Introduction: Implementing early mobilization and minimal sedation in critically ill patients has been shown to be associated with multiple significant positive outcomes. Actiwatches are an established method for monitoring sleep and circadian rhythms in ambulatory patients. It has the potential to be utilized as a way to monitor arousal and mobility in crucially ill patients and possibly replace neurological assessments currently used. This study sought to explore the validity and utility of actiwatches in ascertaining arousal and mobility in critically ill patients: Methods: This study enrolled 32 critically ill patients presented at neurological and medical intensive care units. Actiwatches were placed on participants’ dominant wrist for a period of 24-48 hours and collected data that measured mobility frequency and intensity of activity levels throughout the study period. Throughout the patients’ stay in the ICU, neurological assessments such as Glasgow coma scale and Richmond agitation sedation scale were recorded by qualified nurses’ as normal procedures under the patient plan of care. The activity measures collected from actiwatches were correlated with arousal measures collected from neurological assessments during a 24-hour period and 1 hour bins. Analysis: The activity measures collected from 32 patients were correlated with 550 GCS and 212 RASS measurements as arousal measures. Spearman rho’s correlation between the activity variables showed a strong and significant correlation with both GCS and RASS measurements averaged over a 24-hour period. GCS showed the strongest correlation with average activity levels (p=0.64, p<0.001) and mobility percentage (p=0.57, p<0.001). Correlation relationship between activity and arousal measures were also significant in the 1-hour bins with GCS showing the strongest correlation with both activity levels and mobility frequency (p=0.48, p<0.0001 and p=0.48, p<0.0001) respectively. Activity measures correlations with differentiating between patients’ diagnosis showed significance with GCS for intracerebral but not sepsis patients. Discussion: The analysis over 24-hour period and 1-hour bins both showed a strong significant correlation between GCS scores and activity measures. The RASS scores had a stronger correlation with activity levels over 24-hour period compared to 1-hour bins, although both were significant. These results show promise in utilizing actiwatches as a measure of mobility in critically ill patients. The future direction of this study aims to recruit 200 participants and run more statistical analysis to further support these results and validate actiwatches as a measure of mobility in critically ill patients. The preliminary results, however, support the idea that actiwatches could potentially be utilized as non-invasive, inexpensive methods of monitoring activity levels.