Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

Panchal, S., Arria,
A. & Harris, A.
(2000)
120 Maternal Intensive Care in Belgium KCE Reports 94
8 USA
(Maryland)
1023
obstetric
ICU
admissions
Scoring System (TISS) scores,
intensive care unit course, types of
interventions used and outcome. Endpoints
of therapy included systolic
blood pressure 110–150 mmHg, urine
output ≥ 1 cc/kg/h and oxygen
saturation > 95%.
A retrospective case-control analysis
of state-maintained database of
patient records (Uniform Health
Discharge Data Set). The majority of
the deliveries are included in the
database, home and birthing centre
births are not included. The data was
collected for a 14 year period (1984-
1997). The sampling frame included
all patients with DRG (Diagnosis
Related Grouping) codes from 370-
375 discharged from a Maryland
hospital. All patients admitted to the
ICU sometime during hospital
admission for childbirth were selected
from the HSCRC database and
defined as “cases.” In addition, a
“control,” defined as a woman who
was delivered of a neonate in the
same year, but was not admitted to
the ICU during hospital admission for
delivery, was randomly selected for
each case. Controls were randomly
chosen for each of the 14 yr using
Microsoft Access (Redmond, WA).
Demographic variables included age,
race, payment source, and marital
status. Hospital variables included
source of admission (home or
another hospital) and hospital type
(major teaching, minor teaching, or
Retrospective
case control
analysis of
statemaintained
database of
patient
records
intervention and care typically provided by a general
intensive care unit.
OBJECTIVE: This study reports (1) ICU use and
morality rates in a statewide population of obstetric
patients during their hospital admission for childbirth,
and (2) the risk factors associated with ICU admission
and mortality.
RESULTS: Of the 822,591 hospital admissions for
delivery of neonates during the study period, there were
1,023 ICU admissions (0.12%) and 34 ICU deaths
(3.3O/o). Age, race, hospital type, volume of deliveries,
and source of admission independently and in
combination were associated with ICU admission (P <
0.05). The most common risk factors associated with
ICU admission included cesarean section, preeclampsia
or eclampsia, and postpartum hemorrhage (P < 0.001).
Black race, high hospital volume of deliveries, and longer
duration of ICU stay were associated with ICU mortality
(P < 0.05). The most common risk factors associated
with ICU mortality included pulmonary
CONCLUSIONS: This study shows that ICU use and
mortality rate during hospital admission for delivery of a
neonate is low. These results may influence the location
of perinatal ICU services in the hospital setting. (Key
words: Critically ill obstetric Patient; maternal morbidity;
maternal mofiafiq-) patient records from a statemaintained
anonymous database for the years 1984-1997
was used. Outcome variables included ICU use and
mortality rates.
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