Strobino D M, Frank R, Oberdorf M A, Shachtman R, Kim Y J, Callan N, Nagey D
Department of Maternal and Child Health, Johns Hopkins University, Baltimore, Maryland.
Med Decis Making. 1993 Jan-Mar;13(1):64-73. doi: 10.1177/0272989X9301300109.
The authors used a decision-analytic approach to develop a Maternal Transport Index (MTI) from ACOG guidelines for maternal transport. Data were obtained from three questionnaires administered to five perinatologists, practicing in facilities with various casemixes. Each questionnaire was based on a given level of hospital and contained scenarios describing indications for maternal transport. The MTIs, ratios of the logs of the proportions with given outcomes in Level III hospitals relative to Level I (or II) hospitals, ranged from 1.0 to 26.3 for newborn outcomes. They were greater for Level I hospitals (than Level II) and when newborn outcomes included severe disability as well as death. Within gestational age categories, the MTI was generally greatest for active preterm labor and, within complication categories, for 24-26 or 27-31 weeks' gestation. It was large for maternal outcomes only for two rare acute medical conditions. The MTI has potential use in setting priorities for maternal transport.
作者采用决策分析方法，根据美国妇产科医师学会（ACOG）的孕产妇转运指南制定了孕产妇转运指数（MTI）。数据来自对五名围产医学专家进行的三份调查问卷，这些专家在不同病例组合的医疗机构执业。每份问卷基于特定级别的医院，并包含描述孕产妇转运指征的场景。MTI是三级医院相对于一级（或二级）医院给定结局比例的对数之比，新生儿结局的MTI范围为1.0至26.3。一级医院（相对于二级医院）以及当新生儿结局包括严重残疾和死亡时，MTI更高。在孕周类别中，MTI通常在活跃早产时最高，在并发症类别中，在妊娠24 - 26周或27 - 31周时最高。仅在两种罕见的急性内科疾病中，MTI对于孕产妇结局较大。MTI在确定孕产妇转运的优先顺序方面具有潜在用途。
