Daniela N Vasquez, Andrea V Das Neves, Vanina M Aphalo, Laura Vidal, Miriam Moseinco, Jorge Lapadula, Analía Santa-Maria, Graciela Zakalik, Raúl A Gomez, Mónica Capalbo, Claudia Fernandez, Enrique Agüero-Villareal, Santiago Vommaro, Marcelo Moretti, Silvana B Soli, Florencia Ballestero, Juan P Sottile, Viviana Chapier, Carlos Lovesio, José Santos, Fernando Bertoletti, Fernando A Mos, Alejandro Risso-Vazquez, Mercedes Esteban-Chacon, Santiago Illutovich, Sebastián Chapela, Cecilia I Loudet, José L Scapellato, Alfredo D Intile, Elisa Estenssoro
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引用次数: 1
摘要
目的:探讨因妊娠高血压疾病(HDP)入住ICU的妊娠/产后患者不良孕产妇/胎儿/新生儿结局的相关变量。方法:多中心、前瞻性、国家队列研究。结果:172例患者中与产妇/胎儿/新生儿死亡率独立相关的变量如下:急性生理和慢性健康评估- ii (Acute Physiology and Chronic Health Evaluation-II, APACHE-II)(OR1.20[1.06-1.35])、胎龄(OR0.698[0.59-0.82])和天冬氨酸转氨酶(AST)(OR1.004[1.001-1.006])。头痛、上腹痛和视觉障碍预测综合不良结局的阳性似然比分别为1.23(1.16-1.30)、0.76(0.59-1.02)和1.1(0.98-1.2)。结论:HDP导致的孕产妇/胎儿死亡率与入院时疾病严重程度、胎龄和AST升高独立相关，临床症状预测复合不良结局的准确性较低。
Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study.
Objectives: To explore variables associated with adverse maternal/fetal/neonatal outcomes among pregnant/postpartum patients admitted to ICU for hypertensive disorders of pregnancy (HDP).
Methods: Multicenter, prospective, national cohort study.
Results: Variables independently associated with maternal/fetal/neonatal mortality among 172 patients were as follows: Acute Physiology and Chronic Health Evaluation-II (APACHE-II)(OR1.20[1.06-1.35]), gestational age (OR0.698[0.59-0.82]) and aspartate aminotransferase (AST)(OR1.004[1.001-1.006]). Positive likelihood ratio for headache, epigastric pain, and visual disturbances to predict composite adverse outcomes were 1.23(1.16-1.30), 0.76(0.59-1.02), and 1.1(0.98-1.2), respectively.
Conclusions: Maternal/fetal mortality due to HDP was independently associated with severity of illness on admission, gestational age, and elevated AST. Accuracy of clinical symptoms to predict composite adverse outcomes was low.
期刊介绍：
Hypertension in Pregnancy is a refereed journal in the English language which publishes data pertaining to human and animal hypertension during gestation. Contributions concerning physiology of circulatory control, pathophysiology, methodology, therapy or any other material relevant to the relationship between elevated blood pressure and pregnancy are acceptable. Published material includes original articles, clinical trials, solicited and unsolicited reviews, editorials, letters, and other material deemed pertinent by the editors.
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