Blanco Esquivel Lourdes A, Urbina Jorge Macia, Zerón Hugo Mendieta
"Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Instituto de Salud del Estado de México (ISEM).. Paseo Tollocan, Moderna de la Cruz, 50180 Toluca, México.
"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.
Ghana Med J. 2016 Sep;50(3):129-135.
Severe obstetric morbidity constitutes a serious problem worldwide; however, an effective obstetrical prognosis scale is still missing.
To propose a modified Sequential Organ Failure Assessment Score (SOFA) score based on time before reaching specialized medical attention.
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 PaO/FiO ratio and adding a file of disease evolution time with sepsis prior to reaching specialized medical attention.
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.
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.
None declared.
严重产科并发症是全球范围内的一个严重问题；然而，仍缺少有效的产科预后评估量表。
基于获得专科医疗救治前的时间，提出一种改良的序贯器官衰竭评估评分（SOFA）。
这是一项回顾性和前瞻性相结合的描述性研究，纳入了2009年6月至2013年6月在墨西哥托卢卡市“莫妮卡·普雷泰利尼·萨恩斯”母婴医院产科重症监护病房（OICU）接受治疗的所有女性。每日记录患者的SOFA评分和临床病情演变。构建了改良的产科SOFA量表，将PaO/FiO比值在3分的评分栏中的值调整为180而不是200，并增加了一份在获得专科医疗救治前患有脓毒症的疾病演变时间记录。
232例患者纳入研究，平均年龄（标准差）为26.42（±7.54）岁，平均孕周为33（±7.5）周；118例患有子痫前期，56例产科出血，41例子痫（其中25例之前患有子痫前期），23例脓毒症。在预测孕产妇死亡率方面，ROC曲线显示改良SOFA的曲线下面积（AUC）（0.868；p<0.001）高于SOFA（0.796；p=0.003）。
考虑到较低的Kirby指数值以及在获得专科医疗救治前脓毒症的12小时阈值时间的SOFA评分，对孕产妇死亡具有良好的预测价值，可用于评估复杂产科患者的严重程度。
未声明。
