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Obstetric admissions to intensive care units in Australia and New Zealand: a registry-based cohort study
M J Maiden1,2,3, M E Finnis2,3,4, G J Duke5,6
1Intensive Care Unit, Barwon Health, Geelong, Vic., Australia.
Objective:
Describe the epidemiology of obstetric patients admitted to an Intensive Care Unit (ICU).
Design:
Registry-based cohort study.
Setting:
One hundred and eighty-three ICUs in Australia and New Zealand.
Population:
Women aged 15-49 years, admitted to ICU between 2008 and 2017, classified as pregnant, postpartum or with an obstetric-related diagnosis.
Methods:
Data were extracted from the Australia and New Zealand Intensive Care Society (ANZICS) Adult Patient Database and national agencies.
Main Outcome Measures:
Incidence of ICU admission, cohort characteristics, maternal outcomes and changes over time.
Results:
The cohort comprised 16 063 patients. The annual number of obstetric ICU admissions increased, whereas their proportion of total ICU admissions (1.3%) did not change (odds ratio 1.02, 95% CI 0.99-1.04, P = 0.14). There were 10 518 (65%) with an obstetric-related ICU diagnosis, and 5545 (35%) with a non-obstetric ICU diagnosis. Mean (SD) age was 31 (6.4) years, 1463 (9.1%) were Indigenous, 2305 (14%) were transferred from another hospital, and 3008 (19%) received mechanical ventilation. Median [IQR] length of stay in hospital was 5.2 [3.1-7.9] days, which included 1.1 [0.7-1.8] days in ICU. There were 108 (0.7%) maternal deaths, most (n = 97, 90%) having a non-obstetric diagnosis. There was no change in risk-adjusted length of stay or mortality over time.
Conclusions:
Obstetric patients account for a stable proportion of ICU admissions in Australia and New Zealand. These patients typically have a short length of ICU stay and low hospital mortality.
Tweetable Abstract:
Obstetric patients in Australia/New Zealand ICUs have a short length of ICU stay and low mortality.
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