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Myocardial injury is associated with mortality, but often asymptomatic and currently detected through intermittent cardiac biomarker screening. This delays diagnosis, where vital signs deviations may serve as a proxy for early signs of myocardial injury. This study aimed to assess the association between continuous monitored vital sign deviations and subsequent myocardial injury following major abdominal cancer surgery and during acute exacerbation of chronic obstructive pulmonary disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing major abdominal cancer surgery or admitted with acute exacerbation of chronic obstructive pulmonary disease had daily troponin measurements. Continuous wireless monitoring of several vital signs was performed for up to 96\u00a0h after admission or surgery. The primary exposure was cumulative duration of peripheral oxygen saturation (SpO<jats:sub>2<\/jats:sub>) below 85% in the 24\u00a0h before the primary outcome of myocardial injury, defined as a new onset ischaemic troponin elevation assessed daily. If no myocardial injury occurred, the primary exposure was based on the first 24\u00a0h of measurement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 662 patients were continuously monitored and 113 (17%) had a myocardial injury. Cumulative duration of SpO<jats:sub>2<\/jats:sub>\u00a0&lt;\u00a085% was significantly associated with myocardial injury (mean difference 14.2\u00a0min [95% confidence interval \u22124.7 to 33.1\u00a0min]; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.005). Durations of hypoxaemia (SpO<jats:sub>2<\/jats:sub>\u00a0&lt;\u00a088% and SpO<jats:sub>2<\/jats:sub>\u00a0&lt;\u00a080%), tachycardia (HR\u00a0&gt;\u00a0110\u00a0bpm and HR\u00a0&gt;\u00a0130\u00a0bpm) and tachypnoea (RR\u00a0&gt;\u00a024\u00a0min<jats:sup>\u22121<\/jats:sup> and RR\u00a0&gt;\u00a030\u00a0min<jats:sup>\u22121<\/jats:sup>) were also significantly associated with myocardial injury (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.04, for all).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Duration of severely low SpO<jats:sub>2<\/jats:sub> detected by continuous wireless monitoring is significantly associated with myocardial injury in high\u2010risk patients admitted to hospital wards. The effect of early detection and interventions should be assessed next.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14056","type":"journal-article","created":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T17:59:08Z","timestamp":1646503148000},"page":"674-683","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Continuously monitored vital signs for detection of myocardial injury in high\u2010risk patients \u2013 An observational study"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4754-4756","authenticated-orcid":false,"given":"Frederik C.","family":"Loft","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital University of Copenhagen  Copenhagen Denmark"},{"name":"Copenhagen Center for Translational Research Copenhagen University Hospital Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6297-2871","authenticated-orcid":false,"given":"S\u00f8ren M.","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Digital Health Section Department of Health Technology Technical University of Denmark  Kongens Lyngby Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3601-8432","authenticated-orcid":false,"given":"Mikkel","family":"Elvekjaer","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital University of Copenhagen  Copenhagen Denmark"},{"name":"Copenhagen Center for Translational Research Copenhagen University Hospital Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Anaesthesiology Centre for Cancer and Organ Diseases Rigshospitalet University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8646-5666","authenticated-orcid":false,"given":"Camilla","family":"Haahr\u2010Raunkjaer","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital University of Copenhagen  Copenhagen Denmark"},{"name":"Copenhagen Center for Translational Research Copenhagen University Hospital Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Anaesthesiology Centre for Cancer and Organ Diseases Rigshospitalet University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5716-7600","authenticated-orcid":false,"given":"Helge B. 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