Objective To compare the performance of SOFA,APACHE-Ⅱand OEWS in obstetric ICU admissions to predict the sever maternal outcome.Methods A retrospective study was performed on a total of 363 pregnant and postpartum women admitted to the obstetric ICU of The Affiliated Suzhou Hospital of Nanjing Medical University from January 2015 to December 2018.The scores of SOFA,APACHE-Ⅱand OEWS were calculated by the worst value within 24 hours of admission,and the discrimination and calibration of the three scoring systems for predicting the occurrence of SMO were evaluated.Results A total of 363 pregnant women were admitted to the obstetric ICU,SMO occurred in 152 cases,including 2 maternal death,the incidence of SMO in obstetric ICU was 41.87%,and the maternal mortality was 0.55%.Among all ICU admissions,SOFA had a excellent discrimination(AUC=0.87;95%CI:083-0.91)and was most accurate(cut off=2.5,LR>10)in prediction of SMO;the discrimination of APACHE-Ⅱwas good(AUC=0.804;95%CI:0.757-0.85)and the OEWS was acceptable(AUC=0.701;95%CI:0.646-0.757).When subgroup analysis based on the reason of admission,the performance of the scores were consistent with the overall,whereas APACHE-Ⅱand OEWS significantly underestimating SMO for direct causes,especially for postpartum hemorrhage.Conclusion SOFA may be the first choice for predicting SMO in obstetric ICU;APACHE-Ⅱmay be used secondly,but for direct cause admissions it is not applicable;OEWS is not apply to predict SMO in critically pregnant and puerperal women.A further study to develop and validate the prognosticate scoring system for obstetric critical patients is impendency.
Sever maternal outcomeObstetric intensive care unitPredictive scoring systemSOFAAPACHEⅡOEWS
维普
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