Associations between Anemia and Outcomes of Pregnant Patients with Pyelonephritis.
| Autor: | Cunningham HM; Department of Obstetrics and Gynecology, Yale University, New Haven, Connecticut., Knochenhauer HE; Department of Obstetrics and Gynecology, Staten Island University, Staten Island, New York., Federspiel JJ; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina., Wein LE; Department of Obstetrics and Gynecology, Staten Island University, Staten Island, New York., Denoble AE; Department of Obstetrics and Gynecology, Yale University, New Haven, Connecticut., Heine RP; Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina., Dotters-Katz SK; Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina. |
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| Jazyk: | angličtina |
| Zdroj: | American journal of perinatology [Am J Perinatol] 2024 May; Vol. 41 (S 01), pp. e2403-e2409. Date of Electronic Publication: 2023 Jun 20. |
| DOI: | 10.1055/a-2113-2892 |
| Abstrakt: | Objective: This study aims to determine if pregnant patients with both pyelonephritis and anemia are at an increased risk of adverse maternal outcomes compared with those with pyelonephritis without anemia. Study Design: We conducted a retrospective cohort study utilizing the Nationwide Readmissions Database (NRD). Patients with antepartum pyelonephritis-associated hospitalizations from October 2015 to December 2018 were included. International Classification of Diseases codes were used to identify pyelonephritis, anemia, maternal comorbidities, and severe maternal morbidities. The primary outcome was a composite of severe maternal morbidity, as defined by the Centers for Disease Control criteria. Univariate statistical methods, weighted to account for complex survey methods in the NRD, were used to assess for associations between anemia, baseline characteristics, and patient outcomes. Weighted logistic and Poisson regressions were used to assess for associations between anemia and outcomes, adjusting for clinical comorbidities and other confounding factors. Results: In total, 29,296 pyelonephritis admissions were identified, corresponding to a weighted national estimate of 55,135 admissions. Of these, 11,798 (21.3%) were anemic. The rate of severe maternal morbidity was higher among anemic patients than nonanemic patients (27.8 vs. 8.9%, respectively, p < 0.001), and remained higher after adjustment (adjusted relative risk [aRR] 2.86 [95% confidence interval [CI]: 2.67, 3.06]). Rates of individual components of severe maternal morbidities, including acute respiratory distress syndrome (4.0 vs. 0.6%, aRR 3.97 [95% CI: 3.10, 5.08]), sepsis (22.5 vs. 7.9%, aRR 2.64 [95% CI: 2.45, 2.85]), shock (4.5 vs. 0.6%, aRR 5.48 [95% CI: 4.32, 6.95]), and acute renal failure (2.9 vs. 0.8%, aRR 1.99 [95% CI: 1.55, 2.55]) were all higher for anemic pyelonephritis. The mean length of stay was also longer (25% average increase, 95% CI: 22, 28%). Conclusion: Among pregnant patients with pyelonephritis, those with anemia are at greater risk of severe maternal morbidity and longer hospital stay. Key Points: · Anemia is associated with longer stays for pyelo.. · Anemic pyelo patients have increased morbidity.. · Anemic pyelo patients have increased sepsis risk.. Competing Interests: None declared. (Thieme. All rights reserved.) |
| Databáze: | MEDLINE |
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