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Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study

AIM: Obstetric patients presenting to the intensive care units (ICU) with or without underlying medical or surgical comorbidities can be a challenge to both the treating obstetrician and the intensivist. They occasionally present with near-miss events which if left untreated, can result in death. OB...

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Autores principales: Krishna Kumar, M, Joshi, Aditya, Saraswat, Monica, Jose, Tony, Kapoor, Rajan, Saha, Madhulima, Goyal, Bhupesh Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer India 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8418787/
https://www.ncbi.nlm.nih.gov/pubmed/34511782
http://dx.doi.org/10.1007/s13224-021-01559-x
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author Krishna Kumar, M
Joshi, Aditya
Saraswat, Monica
Jose, Tony
Kapoor, Rajan
Saha, Madhulima
Goyal, Bhupesh Kumar
author_facet Krishna Kumar, M
Joshi, Aditya
Saraswat, Monica
Jose, Tony
Kapoor, Rajan
Saha, Madhulima
Goyal, Bhupesh Kumar
author_sort Krishna Kumar, M
collection PubMed
description AIM: Obstetric patients presenting to the intensive care units (ICU) with or without underlying medical or surgical comorbidities can be a challenge to both the treating obstetrician and the intensivist. They occasionally present with near-miss events which if left untreated, can result in death. OBJECTIVES: To study the prevalence, indications of ICU admissions, near-miss events, and their effect on mortality in obstetric and puerperal patients. MATERIAL & METHODS: We conducted a retrospective analysis of the health records of all the obstetric and puerperal patients (pregnant and until 6 weeks postpartum) admitted to our tertiary care hospital from January 2019 to December 2020. Patient demographic characteristics, obstetric, surgical, and medical conditions, acute physiology, and chronic health evaluation (APACHE) II scores, organ failures, treatment, ICU and hospital length of stay, and mortality outcomes were studied. RESULTS: A total of 22 obstetric patients were admitted to the ICU during the above study period. Mean age was 28.7 ± 6.24 years, mean gestation was 34.4 ± 6.61 weeks, mean APACHE II score was 12.68 ± 5.67, median ICU length of stay was 5 days, and median duration of hospital length of stay was 10 days. The antepartum risk factors such as severe preeclampsia (27%), antepartum bleeding (14%), and postpartum complications like postpartum haemorrhage (33%), sepsis with multiorgan failure (25%) are the commonest indications that resulted in ICU admission. CONCLUSION: Higher APACHE II scores at the time of ICU admission, prolonged ICU, and hospital length of stay may be associated with high maternal mortality.
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spelling pubmed-84187872021-09-07 Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study Krishna Kumar, M Joshi, Aditya Saraswat, Monica Jose, Tony Kapoor, Rajan Saha, Madhulima Goyal, Bhupesh Kumar J Obstet Gynaecol India Original Article AIM: Obstetric patients presenting to the intensive care units (ICU) with or without underlying medical or surgical comorbidities can be a challenge to both the treating obstetrician and the intensivist. They occasionally present with near-miss events which if left untreated, can result in death. OBJECTIVES: To study the prevalence, indications of ICU admissions, near-miss events, and their effect on mortality in obstetric and puerperal patients. MATERIAL & METHODS: We conducted a retrospective analysis of the health records of all the obstetric and puerperal patients (pregnant and until 6 weeks postpartum) admitted to our tertiary care hospital from January 2019 to December 2020. Patient demographic characteristics, obstetric, surgical, and medical conditions, acute physiology, and chronic health evaluation (APACHE) II scores, organ failures, treatment, ICU and hospital length of stay, and mortality outcomes were studied. RESULTS: A total of 22 obstetric patients were admitted to the ICU during the above study period. Mean age was 28.7 ± 6.24 years, mean gestation was 34.4 ± 6.61 weeks, mean APACHE II score was 12.68 ± 5.67, median ICU length of stay was 5 days, and median duration of hospital length of stay was 10 days. The antepartum risk factors such as severe preeclampsia (27%), antepartum bleeding (14%), and postpartum complications like postpartum haemorrhage (33%), sepsis with multiorgan failure (25%) are the commonest indications that resulted in ICU admission. CONCLUSION: Higher APACHE II scores at the time of ICU admission, prolonged ICU, and hospital length of stay may be associated with high maternal mortality. Springer India 2021-09-05 2022-08 /pmc/articles/PMC8418787/ /pubmed/34511782 http://dx.doi.org/10.1007/s13224-021-01559-x Text en © Federation of Obstetric & Gynecological Societies of India 2021
spellingShingle Original Article
Krishna Kumar, M
Joshi, Aditya
Saraswat, Monica
Jose, Tony
Kapoor, Rajan
Saha, Madhulima
Goyal, Bhupesh Kumar
Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study
title Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study
title_full Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study
title_fullStr Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study
title_full_unstemmed Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study
title_short Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study
title_sort near-miss incidents in obstetric patients admitted to an intensive care unit of a tertiary care center in eastern india: a retrospective cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8418787/
https://www.ncbi.nlm.nih.gov/pubmed/34511782
http://dx.doi.org/10.1007/s13224-021-01559-x
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