Prediction of mortality and morbidity by simplified acute physiology score II in obstetric intensive care unit admissions.
BACKGROUND
Critical care in obstetrics has received much attention in recent times. Despite progress in medical field and improvement in health facilities provided, maternal mortality is still very high in most of the developing countries.


OBJECTIVE
To study and analyze records of patients requiring intensive care in obstetrics and to assess utility of simplified acute physiology score (SAPS II) for predicting maternal mortality.


METHODS
A multidisciplinary intensive care unit (ICU) at a tertiary care center.


METHODS
Retrospective review.


METHODS
Fifty-seven consecutive obstetric patients' records requiring ICU admissions were studied for clinical picture, diagnosis, complications, morbidity and mortality over a period of 21/2 years - from 1st May 2002 to 31st Oct. 2004. SAPS II score was calculated according to the different variables for predicting mortality.


METHODS
SAPS II scores were regressed on mortality status using logistic regression analysis. The predictability was assessed by goodness-of-fit test and receiver operated characteristic curve.


RESULTS
Maternal mortality in obstetric ICU admissions was 1.15/1,000 deliveries, amounting to 40.35% of obstetric ICU admissions. The mean SAP II score was significantly higher (40.04 +/- 12.97 vs. 22.6 +/- 7.31) in those patients who died compared to survivors (P < 0.001%).


CONCLUSIONS
The SAPS II accurately predicted mortality in obstetric patients admitted to ICU. Computation of the score as a routine in ICU may help in identifying those at high risk of mortality and then to reduce this risk.
Tempe
Anjali
A
Department of Obstetrics and Gynaecology, Maulana Azad Medical College, Associated Lok Nayak Hospital, New Delhi, India.
Wadhwa
Leena
L
Gupta
Shally
S
Bansal
Siddharth
S
Satyanarayana
Labani
L
D000328:Adult; D016638:Critical Illness / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005544:Forecasting; D006305:Health Status Indicators; D006801:Humans; D007194:India / Q000453:epidemiology; D007362:Intensive Care Units; D007902:Length of Stay; D009017:Morbidity; D009774:Obstetrics; D010343:Patient Admission; D010348:Patient Care Team; D011247:Pregnancy