Boutot M, Margueritte F, Boukeffa N, Coste Mazeau P, Aubard Y, Gauthier T
Service de gynécologie obstétrique, hôpital de la Mère et de l'Enfant, 87000 Limoges, France.
Service de gynécologie obstétrique, hôpital de la Mère et de l'Enfant, 87000 Limoges, France.
Gynecol Obstet Fertil Senol. 2020 Feb;48(2):167-173. doi: 10.1016/j.gofs.2020.01.002. Epub 2020 Jan 7.
FullPIERS score (Pre-eclampsia Integrated Estimate of RiSk) is built in order to predict maternal outcomes among women with preeclampsia. Our objective is to assess external validity of this score among a population of French women.
A retrospective study was conducted for all patients with pre-eclampsia (severe or not) admitted to a tertiary hospital center. A receiver operating characteristic (ROC) curve was constructed to determine accuracy of the model at 48 hours and 7 days after admittance and area under the curve (AUC) was calculated.
In total, 276 patients meet inclusions criterion. Among them, 217 were included and 61 (28 %) had one or more complication. Only 8 patients had two complications at two different moments (one at 48 hours and one at 7 days). The FullPiers score predicted maternels events at 48 hours with an area under the curve at 0.80 (IC95 % [0.74-0.85]). At 4.2 cut off, the sensitivity was 71 % and specifity 88 %. At 7 days, the area under the curve was 0.74 (IC95 % [0.67-0.79]), admiting a cutoff point for FullPIERS probability of 3.4, sensitivity was 59 % and specificity 85 %.
Our study show utility of FullPIERS score in french maternity. This model might be a useful tool for predicting complications in women with pre-eclampsia. Using of this score in clinical practice might help improving optimization of patient's care.
构建全面PIERS评分（先兆子痫风险综合评估）以预测先兆子痫女性的孕产妇结局。我们的目的是评估该评分在法国女性人群中的外部有效性。
对一家三级医院中心收治的所有先兆子痫患者（无论严重与否）进行回顾性研究。构建受试者工作特征（ROC）曲线以确定入院后48小时和7天时模型的准确性，并计算曲线下面积（AUC）。
共有276例患者符合纳入标准。其中，217例被纳入研究，61例（28%）发生了一种或多种并发症。只有8例患者在两个不同时间点出现了两种并发症（一个在48小时，一个在7天）。全面PIERS评分在48小时时预测孕产妇事件的曲线下面积为0.80（95%置信区间[0.74 - 0.85]）。截断值为4.2时，敏感性为71%，特异性为88%。在7天时，曲线下面积为0.74（95%置信区间[0.67 - 0.79]），全面PIERS概率的截断点为3.4，敏感性为59%，特异性为85%。
我们的研究表明全面PIERS评分在法国产妇中具有实用性。该模型可能是预测先兆子痫女性并发症的有用工具。在临床实践中使用该评分可能有助于改善患者护理的优化。
