Defining 'obstetric haemorrhage': Blood loss volume and severe morbidity.

Autor:	Wang, Michelle J., Alexander, Megan, Abbas, Diana, Srivastava, Akanksha, Comfort, Ashley, Iverson, Ronald, Cabral, Howard J., Yarrington, Christina
Předmět:	DISEASE risk factors POSTPARTUM hemorrhage PREDICTIVE tests RETROSPECTIVE studies SEVERITY of illness index RISK assessment URBAN hospitals COMPARATIVE studies RESEARCH funding SAFETY-net health care providers DISEASE prevalence DESCRIPTIVE statistics RECEIVER operating characteristic curves DATA analysis SENSITIVITY & specificity (Statistics) DATA analysis software LONGITUDINAL method SECONDARY analysis DISEASE complications
Zdroj:	Journal of Evaluation in Clinical Practice; Feb2024, Vol. 30 Issue 1, p37-41, 5p
Abstrakt:	Aims and Objectives: Our goal is to describe the association between total quantitative blood loss (QBL) and risk of obstetric haemorrhage‐related morbidity (OBH‐M) to assess the utility of the current definition of obstetric haemorrhage (OBH). Methods: This was a retrospective cohort study completed of all patients who had a live delivery at the only urban safety‐net hospital over a 2‐year period from 2018 to 2019. We categorized deliveries into 10 equally sized deciles based on QBL and compared the proportion with OBH‐M in each. Among the two deciles with the highest proportions of OBH‐M, we stratified deliveries into seven groups of ascending intervals of 250cc QBL. Finally, we compared the positive predictive value (PPV) of the standard definition of OBH (QBL ≥ 1000cc) to a definition extrapolated from our stratified analysis. The primary outcome was proportion of deliveries within each QBL decile affected by OBH‐M. The secondary outcome was PPV. Results: We found a significant increase in OBH‐M from decile 9 (895–1201cc QBL) to decile 10 (1205–8325cc QBL) (p < 0.001). In our stratified analysis, we found QBL of 1500cc to be an inflection point for an increased proportion of OBH‐M. Our secondary analysis showed an increased PPV for OBH‐M using QBL of 1500cc (20.5%) compared with that of QBL 1000cc (9.8%). Conclusions: Our findings suggest that a higher QBL threshold than the currently accepted definition of OBH is more predictive of OBH‐M. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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