Khergade Monali, Suri Jyotsna, Bharti Rekha, Pandey Divya, Bachani Sumitra, Mittal Pratima
Department of Obstetrics and Gynecology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Indian J Crit Care Med. 2020 Jun;24(6):398-403. doi: 10.5005/jp-journals-10071-23453.
Obstetric early warning score (OEWS) has been used conventionally for early identification of deteriorating obstetric patients in the labor room and ward settings. This study was conducted to determine if this simple clinical score could be used for prognosticating a critically ill patient in the ICU setting instead of sequential organ failure assessment score (SOFA) and acute physiology and chronic health evaluation (APACHE II) score.
A cohort study was conducted at Obstetrics Critical Care Unit, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. A total of 250 obstetric patients were recruited after informed consent. The OEWS, SOFA, and APACHE II scores were calculated within 24 hours of admission. The patients were followed to study the maternal outcome.
The area under receiver operator characteristic (AUROC) curve of OEWS, SOFA, and APACHE II for prediction of maternal mortality was 0.894 (95% CI, 0.849-0.929), 0.924 (95% CI, 0.884-0.954), and 0.93 (95% CI, 0.891-0.958), respectively. The standardized mortality ratio (SMR) for OEWS, SOFA, and APACHE II was 66.3, 62.5, and 69.15%, respectively.
Obstetric early warning score is as effective as the conventional SOFA and APACHE II to prognosticate the obstetric patient. Since OEWS is based only on clinical criteria, it can be done immediately on admission and can help in early allocation of appropriate manpower and resources for optimum outcome.
The clinical application of this study will help intensivists to prognosticate the critically ill obstetric patients immediately following admission to the critical care unit.
Khergade M, Suri J, Bharti R, Pandey D, Bachani S, Mittal P. Obstetric Early Warning Score for Prognostication of Critically Ill Obstetric Patient. Indian J Crit Care Med 2020;24(6):398-403.
产科早期预警评分（OEWS）传统上用于产房和病房环境中对病情恶化的产科患者进行早期识别。本研究旨在确定这个简单的临床评分是否可用于重症监护病房（ICU）环境中对危重症患者进行预后评估，而非序贯器官衰竭评估评分（SOFA）和急性生理与慢性健康状况评估（APACHE II）评分。
在新德里的瓦尔丹·马哈拉施特拉医学院和萨夫达容医院的产科重症监护病房进行了一项队列研究。在获得知情同意后，共招募了250名产科患者。在入院后24小时内计算OEWS、SOFA和APACHE II评分。对患者进行随访以研究孕产妇结局。
OEWS、SOFA和APACHE II预测孕产妇死亡率的受试者工作特征曲线下面积（AUROC）分别为0.894（95%可信区间，0.849 - 0.929）、0.924（95%可信区间，0.884 - 0.954）和0.93（95%可信区间，0.891 - 0.958）。OEWS、SOFA和APACHE II的标准化死亡率比（SMR）分别为66.3%、62.5%和69.15%。
产科早期预警评分在预测产科患者预后方面与传统的SOFA和APACHE II评分同样有效。由于OEWS仅基于临床标准，入院时即可立即进行，有助于早期分配适当的人力和资源以实现最佳结局。
本研究的临床应用将有助于重症监护医生在危重症产科患者入住重症监护病房后立即对其进行预后评估。
Khergade M, Suri J, Bharti R, Pandey D, Bachani S, Mittal P. 用于危重症产科患者预后评估的产科早期预警评分。《印度重症监护医学杂志》2020；24(6):398 - 403。
