Sheela C N, Veni Nekkilady, Vinotha Ponnusamy, Sumithra Selvam
1St. John's Medical College, No. 562, 1st Cross, K G Layout, BSK 3rd Stage, 3rd Phase, Bangalore, 560085 India.
2MS Ramaiah Medical College, No. 5, 2nd A Cross, Suraveena, Near Jayadurga Kalyana Mantap, J C Nagar, Mahalaxmipuram, Bangalore, 560086 India.
J Obstet Gynaecol India. 2019 Oct;69(5):399-404. doi: 10.1007/s13224-019-01226-2. Epub 2019 Apr 22.
To validate the new cardiac risk scoring system, Sheela's Cardiac Disease in Pregnancy (SHE-CDIP), in predicting the cardiac complications in women with cardiac disease in pregnancy.
The study was conducted at a tertiary care hospital in South India, over a period of 5 years from January 2010 to January 2015. Pregnant women with heart disease included in this study were 102, and data was collected from medical records. Risk Score was calculated at booking according to both the new scoring system (SHE-CDIP) and the standard CARPREG scoring system. The validation was done by assessing the ability of the new scoring system to predict maternal cardiac complications by comparing with the CARPREG scoring system.
The validation of the SHE-CDIP score was done against CARPREG score using cross tabulation between current cardiac risk score with CARPREG score. McNemar square test was done to compare the proportion between two scoring methods. Agreement between CARPREG and SHE-CDIP risk score was analyzed using Kappa statistics, and accuracy was reported.
Comparing the two risk scores using Kappa statistics, accuracy and good agreement were noted (kappa = 0.70). Sensitivity of 83%, specificity of 88%, positive predictive value of 86% and negative predictive value of 84% for the SHE-CDIP scoring system were noted.
The new risk score (SHE-CDIP) would be useful to stratify the risk in Indian cohort of women with cardiac disease in pregnancy as it is population specific.
验证新的心脏风险评分系统——希拉妊娠期心脏病评分系统（SHE-CDIP），以预测妊娠期心脏病女性的心脏并发症。
本研究在印度南部的一家三级护理医院进行，时间跨度为2010年1月至2015年1月的5年期间。本研究纳入的患有心脏病的孕妇有102例，并从病历中收集数据。根据新的评分系统（SHE-CDIP）和标准的CARPREG评分系统在登记时计算风险评分。通过与CARPREG评分系统比较，评估新评分系统预测孕产妇心脏并发症的能力来进行验证。
使用当前心脏风险评分与CARPREG评分的交叉表，对SHE-CDIP评分与CARPREG评分进行验证。采用McNemar平方检验比较两种评分方法的比例。使用Kappa统计分析CARPREG和SHE-CDIP风险评分之间的一致性，并报告准确性。
使用Kappa统计比较两个风险评分，发现准确性和良好的一致性（kappa = 0.70）。SHE-CDIP评分系统的敏感性为83%，特异性为88%，阳性预测值为86%，阴性预测值为84%。
新的风险评分（SHE-CDIP）对于对印度妊娠期心脏病女性队列进行风险分层很有用，因为它是针对特定人群的。
