Lourdes A Blanco Esquivel1, Jorge Macia Urbina1, Hugo Mendieta Zerón2. 1. "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Instituto de Salud del Estado de México (ISEM).. Paseo Tollocan, Moderna de la Cruz, 50180 Toluca, México. 2. "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Instituto de Salud del Estado de México (ISEM).. Paseo Tollocan, Moderna de la Cruz, 50180 Toluca, México; Ciprés Grupo Médico (CGM) and Asociación Científica Latina (ASCILA). Felipe Villanueva sur 700, Col. Morelos, 50120, Toluca, México.
Abstract
BACKGROUND: Severe obstetric morbidity constitutes a serious problem worldwide; however, an effective obstetrical prognosis scale is still missing. OBJECTIVE: To propose a modified Sequential Organ Failure Assessment Score (SOFA) score based on time before reaching specialized medical attention. METHOD: This was an ambispective, descriptive study, including all women treated at the Obstetrical Intensive Care Unit (OICU) of the "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2009 to June 2013. The patient's SOFA score and clinical evolution were registered daily. A modified obstetrical SOFA scale was constructed adjusting the value of 180 instead of 200 in the punctuation column of 3 for the PaO2/FiO2 ratio and adding a file of disease evolution time with sepsis prior to reaching specialized medical attention. RESULTS: Two hundred thirty two patients, with an average age (SD) of 26.42 (±7.54) years, mean gestational age of 33 (±7.5) weeks were included in the study; 118 suffered from pre-eclampsia, 56 obstetric haemorrhages, 41 eclampsia (25 preceded by pre-eclampsia) and 23, sepsis. ROC curves showed a higher area under the curve (AUC) for the modified SOFA (0.868; p<0.001) than SOFA (0.796; p=0.003), in the prediction of maternal mortality. CONCLUSIONS: The SOFA score, taking into account a lower value for the Kirby index and a threshold time of 12-h with sepsis before getting specialized medical attention, shows a good predictive value for maternal death and could be considered for evaluating the severity of complicated obstetrical patients. FUNDING: None declared.
BACKGROUND: Severe obstetric morbidity constitutes a serious problem worldwide; however, an effective obstetrical prognosis scale is still missing. OBJECTIVE: To propose a modified Sequential Organ Failure Assessment Score (SOFA) score based on time before reaching specialized medical attention. METHOD: This was an ambispective, descriptive study, including all women treated at the Obstetrical Intensive Care Unit (OICU) of the "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2009 to June 2013. The patient's SOFA score and clinical evolution were registered daily. A modified obstetrical SOFA scale was constructed adjusting the value of 180 instead of 200 in the punctuation column of 3 for the PaO2/FiO2 ratio and adding a file of disease evolution time with sepsis prior to reaching specialized medical attention. RESULTS: Two hundred thirty two patients, with an average age (SD) of 26.42 (±7.54) years, mean gestational age of 33 (±7.5) weeks were included in the study; 118 suffered from pre-eclampsia, 56 obstetric haemorrhages, 41 eclampsia (25 preceded by pre-eclampsia) and 23, sepsis. ROC curves showed a higher area under the curve (AUC) for the modified SOFA (0.868; p<0.001) than SOFA (0.796; p=0.003), in the prediction of maternal mortality. CONCLUSIONS: The SOFA score, taking into account a lower value for the Kirby index and a threshold time of 12-h with sepsis before getting specialized medical attention, shows a good predictive value for maternal death and could be considered for evaluating the severity of complicated obstetrical patients. FUNDING: None declared.
Entities:
Keywords:
Intensive Care Units; Sequential Organ Failure; maternal mortality
Authors: Catherine M Albright; Tariq N Ali; Vrishali Lopes; Dwight J Rouse; Brenna L Anderson Journal: Am J Obstet Gynecol Date: 2014-03-12 Impact factor: 8.661
Authors: Felicitas Geier; Steffen Popp; Yvonne Greve; Andreas Achterberg; Erika Glöckner; Renate Ziegler; Hans Jürgen Heppner; Harald Mang; Michael Christ Journal: Wien Klin Wochenschr Date: 2013-08-10 Impact factor: 1.704