Related Experiment Video
Updated: Jun 7, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
The usefulness of a 28-item Therapeutic Intervention Scoring System (TISS-28) in critically ill obstetric patients to
Jose Rojas-Suarez1, Jeniffer González-Hernández2, Diana Borre-Naranjo2
1Intensive Care and Obstetric Research Group (GRICIO), Universidad de Cartagena, Cartagena, Colombia; Corporación Universitaria Rafael Núñez, Cartagena, Colombia.
Background:
This study evaluated the effectiveness of the 28-item Therapeutic Intervention Scoring System (TISS-28) in detecting multiorgan dysfunction (MOD) among critically ill obstetric patients and compared its predictive potential to other severity models, such as Sequential Organ Failure Assessment (SOFA) and Mortality Probability Model II (MPM II).
Methods:
A prospective multicentre cohort study was conducted including obstetric patients, pregnant and up to 42 days postpartum, admitted to the intensive care units of two referral hospitals in Colombia. A total of 93 patients were recruited between March 2016 and February 2017 and from September 2019 to November 2019. Scores from the MPM II, SOFA, and TISS-28 were calculated within the first 24 h post-intensive care unit admission. The primary outcome was to evaluate the effectiveness of TISS-28 in predicting MOD, as defined by the World Health Organization near-miss criteria. We compared the TISS-28 with SOFA and MPM II scores in identifying MOD using the positive predictive value, negative predictive value, and the area under the receiver operating characteristic curve.
Results:
Data from 93 patients were analysed, of whom 22 developed MOD. Hypertensive disorders were the predominant diagnosis (n = 62; 66.7%). Patients with sepsis exhibited the highest TISS-28 score, indicating more intensive therapeutic interventions. The areas under the receiver operating characteristic curve for TISS-28, SOFA, and MPM II were 0.83 (95% confidence interval: 0.73-0.92), 0.66 (0.51-0.80), and 0.59 (0.43-0.74), respectively (p = 0.001). The cut-off value of a TISS-28 score ≥21 was associated with an increased likelihood of MOD (sensitivity: 83.2%, specificity: 71.2%), a positive predictive value of 47.3%, and a negative predictive value) of 93.2%.
Conclusions:
TISS-28 demonstrated robust performance in identifying MOD among obstetric patients compared to other severity indexes. The TISS-28 score complements physiology-derived severity scores by reflecting the level of care required, making it a valuable tool in risk stratification and resource allocation for critically ill obstetric patients.
Insights
The 28-item Therapeutic Intervention Scoring System (TISS-28) effectively identifies multiorgan dysfunction (MOD) in critically ill obstetric patients. TISS-28 offers valuable insights for risk stratification and resource allocation in obstetric intensive care units.
Area of Science:
- Critical Care Medicine
- Obstetrics
- Health Services Research
Background:
- Critically ill obstetric patients require accurate severity assessment.
- Existing models like SOFA and MPM II may not fully capture care intensity.
- The 28-item Therapeutic Intervention Scoring System (TISS-28) is evaluated for its utility in this population.
Purpose of the Study:
- To evaluate the effectiveness of TISS-28 in detecting multiorgan dysfunction (MOD) in critically ill obstetric patients.
- To compare TISS-28's predictive performance against SOFA and MPM II.
- To assess TISS-28's utility in risk stratification and resource allocation.
Main Methods:
- Prospective multicentre cohort study in Colombian ICUs.
- Included 93 obstetric patients (pregnant to 42 days postpartum).
- TISS-28, SOFA, and MPM II scores collected within 24h of ICU admission; MOD defined by WHO near-miss criteria.
Main Results:
- TISS-28 showed a significantly higher area under the ROC curve (0.83) compared to SOFA (0.66) and MPM II (0.59) (p=0.001).
- A TISS-28 cut-off score ≥21 demonstrated 83.2% sensitivity and 71.2% specificity for MOD.
- TISS-28 yielded a positive predictive value of 47.3% and a negative predictive value of 93.2% for MOD.
Conclusions:
- TISS-28 is a robust tool for identifying MOD in critically ill obstetric patients.
- TISS-28 complements physiological scores by reflecting care intensity.
- TISS-28 aids in risk stratification and resource allocation for this patient group.
More Related Videos
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
11:27A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023