Continuous wearable monitoring after surgery can significantly reduce the time patients spend with dangerously low oxygen levels, according to new research from the Wake Forest University School of Medicine. The study, conducted at Atrium Health Wake Forest Baptist Medical Center, is the largest randomized crossover trial to date evaluating wearable monitoring on surgical wards.
In many hospitals, patients on general wards are monitored through intermittent vital sign checks, typically every four to six hours. While standard practice, this approach can miss early warning signs of clinical deterioration. The study therefore compared routine spot checks with a continuous wearable monitoring system that measures oxygen saturation, heart rate and blood pressure every 15 seconds.
Over the course of a year, nearly 3,700 postoperative patients, including around 800 high-risk individuals, were included in the analysis. The study design alternated monitoring methods across two surgical units every four weeks, allowing for direct comparison between the two approaches. The results were published in JAMA Network Open.
Reduced hypoxemia and improved outcomes
The findings show that continuous monitoring can meaningfully reduce hypoxemia, periods in which oxygen saturation drops below safe levels. Patients using the wearable system spent approximately 30 fewer minutes with oxygen saturation below 90%, representing a statistically significant 14% reduction in risk for dangerous desaturation events.
“Even modest amounts of hypoxemia may meaningfully affect recovery and could possibly be an early indicator of a downstream clinical event,” said lead author Ashish K. Khanna, professor of anesthesiology and vice chair of research at Wake Forest.
In addition to oxygen-related improvements, composite outcomes, combining abnormalities in oxygen levels, heart rate and blood pressure, also showed significant improvement with continuous monitoring. Although individual safety outcomes did not reach statistical significance, trends pointed to fewer ICU transfers, fewer rapid response activations and lower in-hospital mortality.
Enabling earlier intervention
A key advantage of continuous monitoring lies in its ability to provide real-time physiological data and alerts. This enables care teams to intervene earlier, for example by repositioning a patient’s airway, stimulating the patient or administering supplemental oxygen. “These earlier bedside interventions likely contributed to the improved outcomes observed in the study,” the researchers noted.
With hundreds of millions of surgeries performed worldwide each year, the postoperative phase remains a high-risk period. Continuous wearable monitoring offers a scalable and practical solution to improve patient safety and reduce preventable complications.
“This trial shows that real-time visibility into patient physiology helps teams respond sooner and more effectively,” Khanna said. “Continuous wearable monitoring is no longer experimental. It's achievable, impactful and ready for broader adoption.”
