• Medicina intensiva · Apr 2021

    Comparison of four prognostic scales for predicting mortality in patients with severe maternal morbidity.

    • B Jonguitud López, D Álvarez Lara, M A Sosa Medellín, F Montoya Barajas, and G C Palacios Saucedo.
    • Unidad de Cuidados Intensivos, Hospital de especialidades en la Unidad Médica de Alta Especialidad N.(o) 25, IMSS, Monterrey, Nuevo León, México. Electronic address: jl_bal@hotmail.com.
    • Med Intensiva. 2021 Apr 1; 45 (3): 156-163.

    ObjectiveTo compare the prognostic validity of the APACHE II-M and O-SOFA scales versus the APACHE II and SOFA to predict mortality in patients with severe maternal morbidity.DesignA retrospective, longitudinal and analytical cohort study was carried out.SettingMedical-surgical intensive care unit (ICU) of a tertiary hospital.PatientsPregnant or puerperal patients of any age admitted to the ICU.InterventionsCalculation of prognostic scores upon admission.Variables Of InterestAPACHE II, SOFA, APACHE II-M and O-SOFA scores and maternal mortality.ResultsA total of 141 patients were included. The majority (70.2%) were puerperal. The most frequent diagnosis was gestational hypertensive disease (50 cases). The discrimination of each prognostic model was estimated with the area under the ROC curve (AUC-ROC). The calibration was estimated using the mortality ratio and the Hosmer-Lemeshow statistic. The four scales discriminated between survivors and non-survivors with areas under the curve >0.85. The APACHE II-M model was the predictive model with the highest discrimination and calibration. In the Hosmer-Lemeshow regression analysis, mortality as predicted by the APACHE II and O-SOFA was significantly different from the observed mortality.ConclusionsThe APACHE II-M exhibited the greatest prognostic validity in predicting maternal mortality. This difference was given by its improvement in calibration.Copyright © 2019 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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