20% of recently released hospital patients have abnormal vital signs

Patients who walk out of the hospital are not always 100 percent healthy. But researchers from the University of Texas Southwestern Medical Center in Dallas, found roughly 20 percent of those discharged from the hospital did not have entirely stable vital signs.

The length of hospital stays has steadily decreased over the past 30 years, meaning the need to evaluate discharged patients has grown. Researchers analyzed EMRs of 32,835 patients from six Texas hospitals, including statistics on abnormalities in temperature, heart rate, blood pressure, respiratory rate and oxygen saturation within 24 hours of discharge.

"We found that nearly one in five hospitalized adults is discharged with one or more vital sign instabilities such as an elevated heart rate or low blood pressure," said lead author, Oanh Nguyen, MD, an assistant professor at UT. "This finding is an important patient safety issue because patients who had vital sign abnormalities on the day of discharge had higher rates of hospital readmission and death within 30 days even after adjusting for many other risk factors."

Other findings about 13 percent were readmitted into the hospital or died, and patients with three or more abnormalities were four times more likely to die.

With these results, researchers released tips to help control mortalities and readmissions, including:

• Discharge guidelines should include objective vital sign criteria for judging stability on discharge to improve disposition planning and post-discharge patient safety.
• Patients with even one abnormality should be discharged with caution.
• Follow-up and patient education should be provided.
• Patients with two or more abnormalities should remain in the hospital and continue treatment.