Continuous monitoring using a predictive instrument

• US 5,718,233 A
• Filed: 01/11/1996
• Issued: 02/17/1998
• Est. Priority Date: 08/01/1994
• Status: Expired due to Term

• Current Assignee: New England Medical Center Hospitals, Inc.
• Original Assignee: New England Medical Center Hospitals, Inc.
• Inventors: Selker, Harry P., Griffith, John L.
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US08/584,048
• Time in Patent Office: 768 Days
• Field of Search: 128/696, 128/702, 128/703, 128/704, 128/705, 364/413.06
• US Class Current: 600/509
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

An instrument for continuously monitoring the condition of a patient who has a cardiovascular disease, the instrument including an electrocardiograph; a waveform analyzer which analyzes a current segment of an ECG waveform; a computer receiving output from the waveform analyzer; and a control module. The computer is programmed to complete a monitoring cycle in which the computer uses the output from the waveform analyzer to compute a probability of a life threatening cardiac condition based upon the current segment of the patient'"'"'s ECG waveform. The control module causes the computer to periodically repeat the monitoring cycle and for each repetition of said monitoring cycle to compute a change-of-condition measure, wherein the change-of-condition measure is calculated by subtracting a computed probability for a previous monitoring cycle from the computed probability for the current monitoring cycle. The computer is also programmed to compare during each monitoring cycle the computed change-of-condition measure for that monitoring cycle to a threshold value and if in excess of the threshold value to generate an alarm notification.

Claims

1. A system for continuously monitoring the condition of a patient who has a cardiovascular disease, said system comprising:

an electrocardiograph which during use is connected to the patient;

a waveform analyzer which analyzes a segment of an ECG waveform generated by the electrocardiograph for the patient;

a predictive instrument receiving output from the waveform analyzer, said predictive instrument programmed to complete a monitoring cycle in which the predictive instrument uses the output from the waveform analyzer to compute a probability of a life threatening cardiac condition based upon the segment of the patient'"'"'s ECG waveform; and

a detector module which receives computed probabilities from the predictive instrument for a sequence of monitoring cycles and for each monitoring cycle is programmed to compute a change-of-condition measure, wherein said change-of-condition measure is calculated by subtracting a computed probability for a previous monitoring cycle from the computed probability for a current monitoring cycle,

said detector module further programmed to compare during each monitoring cycle the computed change-of-condition measure for that monitoring cycle to a threshold value and if in excess of said threshold value to generate an alarm notification.

2. The system of claim 1 wherein the detector module is further programmed to cause said predictive instrument to perform said sequence of monitoring cycles.

3. The system of claim 2 further comprising a computer and wherein the waveform analyzer and the detection module are both implemented by said computer.

4. The system of claim 1 further comprising an input device for entering clinical information relating to the patient and wherein said predictive instrument uses the output from the waveform analyzer as well as the clinical information entered through said input device to compute the probability of a life threatening cardiac condition.

5. The system of claim 1 wherein the probability of a life threatening cardiac condition is a probability that the patient has acute cardiac ischemia.

6. The system of claim 1 wherein the probability of a life threatening cardiac condition is a probability of acute hospital mortality for the patient.

7. The system of claim 1 wherein the predictive instrument uses a logistic regression equation to compute the probability of a life threatening cardiac condition.

8. The system of claim 1 wherein the control module is programmed to cause said computer to repeat the monitoring cycle at regular intervals separated by a preselected delay.

9. A method for continuously monitoring the condition of a patient who has a cardiovascular disease, said method comprising:

using an electrocardiograph to generate an EKG waveform for the patient;

analyzing said EKG waveform;

based on analyzing said EKG waveform, periodically computing a probability of a life threatening cardiac condition based upon the patient'"'"'s ECG waveform;

from the periodically computed probability, periodically computing a change-of-condition measure, wherein said change-of-condition measure represents a difference between a previously computed probability and a more recent computed probability;

periodically comparing the periodically computed change-in-condition measure to a threshold value; and

if any computed change-in-condition measure exceeds said threshold value, generating an alarm notification.