Title | Validating the Performance of the Modified Early Obstetric Warning System Multivariable Model to Predict Maternal Intensive Care Unit Admission. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Ryan, H, Jones, M, Payne, BA, Sharma, S, Hutfield, A, Lee, T, Ukah, V, Walley, K, Magee, LA, von Dadelszen, P |
Journal | J Obstet Gynaecol Can |
Volume | 39 |
Issue | 9 |
Pagination | 728-733.e3 |
Date Published | 2017 Sep |
ISSN | 1701-2163 |
Abstract | OBJECTIVES: To evaluate the performance of the Modified Early Obstetric Warning System (MEOWS) to predict maternal ICU admission in an obstetric population. DESIGN: Case-control study. SETTING: Two maternity units in Vancouver, Canada, one with ICU facilities, between January 1, 2000, and December 31, 2011. PATIENTS: Pregnant or recently delivered (≤6 weeks) women admitted to the hospital for >24 hours. Three control patients were randomly selected per case and matched for year of admission. MEASUREMENTS AND MAIN RESULTS: Retrospective, observational, case-control validation study investigating the physiologic predictors of admission in the 24-hour period preceding either ICU admission >24 hours (cases) or following admission (control patients). Model performance was assessed based on sensitivity, specificity, and predictive values. Forty-six women were admitted to the ICU for >24 hours (0.51/1000 deliveries); the study included 138 randomly selected control patients. There were no maternal deaths in the cohort. MEOWS had high sensitivity (0.96) but low specificity (0.54) for ICU admission >24 hours, whereas ≥1 one red trigger maintained sensitivity (0.96) and improved specificity (0.73). CONCLUSION: Altering MEOWS trigger parameters may improve the accuracy of MEOWS in predicting ICU admission. Formal modelling of a MEOWS scoring system is required to support evidence-based care. |
DOI | 10.1016/j.jogc.2017.01.028 |
Alternate Journal | J Obstet Gynaecol Can |
Citation Key | 614 |
PubMed ID | 28566256 |