• Tricia T Gilbert, John C Smulian, Andrew A Martin, Cande V Ananth, William Scorza, Anthony T Scardella, and Critical Care Obstetric Team.
• Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School/Saint Peter's University Hospital, New Brunswick, New Jersey 08901, USA.
• Obstet Gynecol. 2003 Nov 1;102(5 Pt 1):897-903.

ObjectiveTo determine whether mortality prediction based on a current model of outcome prediction is accurate in obstetric patients.MethodsConsecutive obstetric admissions to a medical intensive care unit from 1991 to 1998 were reviewed to determine whether mortality prediction is feasible in obstetric patients based on a widely used model. The Simplified Acute Physiologic Score (SAPS II) was used to predict the probability of hospital mortality.ResultsThe Simplified Acute Physiologic Score overestimated mortality in all patients (19 predicted deaths, eight observed) but accurately predicted mortality in patients admitted to the intensive care unit for medical reasons (seven predicted, five observed). The Simplified Acute Physiologic Score did not predict mortality in patients admitted for obstetric indications or postpartum hemorrhage. Median SAPS II scores were significantly higher in those patients who died, compared with survivors. For all groups, SAPS II scores were correlated with intensive care unit length of stay but not hospital length of stay.ConclusionThe Simplified Acute Physiologic Score accurately predicts hospital mortality in obstetric patients admitted to the intensive care unit for medical reasons but not for indications related to pregnancy and delivery. An alternate model that predicts outcomes in obstetric patients admitted for obstetric indications should be developed.

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