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Critically ill obstetrical patients: outcome and predictability

G Lewinsohn1, A Herman, Y Leonov

  • 1Department of Critical Care Medicine, Assaf-Harofeh Medical Center, Zerifin, Israel.

Critical Care Medicine
|September 1, 1994
PubMed
Summary
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Critically ill obstetrical patients had better outcomes than predicted by the APACHE II score. This suggests pregnancy-related physiological changes or improved care may influence intensive care unit (ICU) outcomes.

Area of Science:

  • Critical care medicine
  • Obstetrics
  • Health outcomes research

Background:

  • The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system is widely used to predict mortality in intensive care unit (ICU) patients.
  • Its applicability in specific patient subgroups, such as critically ill obstetrical patients, requires validation.

Purpose of the Study:

  • To assess the accuracy of the APACHE II scoring system in predicting outcomes for critically ill obstetrical patients.
  • To compare the predicted versus actual mortality in this specific patient population.

Main Methods:

  • Retrospective data collection from a multidisciplinary university hospital ICU.
  • Analysis of 58 critically ill obstetrical patients admitted over an 8-year period.
  • Comparison with non-obstetrical young women and general ICU patient groups.

Related Experiment Videos

Main Results:

  • Obstetrical patients had a mean APACHE II score of 11, with a predicted mortality risk of 16.6%.
  • Actual mortality was significantly lower than predicted (mortality ratio 0.416, p = .021).
  • Non-obstetrical groups showed mortality ratios close to 1, indicating predicted mortality aligned with actual outcomes.

Conclusions:

  • Critically ill obstetrical patients in this ICU experienced better outcomes than predicted by the APACHE II system.
  • Potential explanations include unique physiological changes associated with pregnancy or improvements in care specific to this subgroup.
  • Further research is warranted to understand factors influencing outcomes in this population.