Assessing the Incremental Value of Blood Oxygen Saturation (SpO2) in the miniPIERS (Pre-eclampsia Integrated Estimate of RiSk) Risk Prediction Model
| Autor: | Laura A. Magee, Rozina Sikandar, Jennifer A. Hutcheon, Garth Cloete, Erika van Papendorp, Beth A. Payne, Rahat Qureshi, J. Mark Ansermino, Dustin Dunsmuir, Joanne Lim, Guy A. Dumont, David Hall, Peter von Dadelszen |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty Adverse outcomes Logistic regression Risk Assessment Preeclampsia Young Adult Pre-Eclampsia Pregnancy Internal medicine Positive predicative value medicine Humans Prospective Studies Prospective cohort study Oxygen saturation (medicine) Eclampsia medicine.diagnostic_test business.industry fungi Obstetrics and Gynecology medicine.disease Surgery Oxygen Pulse oximetry Cardiology Female business Blood Gas Monitoring Transcutaneous |
| Zdroj: | Journal of Obstetrics and Gynaecology Canada. 37:16-24 |
| ISSN: | 1701-2163 |
| Popis: | To assess the incremental value of blood oxygen saturation (SpO(2)) as a predictor in the miniPIERS model, a risk prediction model for adverse outcomes among women with a diagnosis of hypertensive disorder of pregnancy (HDP) in low-resourced settings.Using data from a prospective cohort including 852 women admitted to hospital for a HDP, the association between SpO(2) and adverse maternal outcome was assessed using logistic regression. The miniPIERS model was recalibrated and extended to include SpO(2). The incremental value of adding SpO(2) to the model was measured using a net reclassification index (NRI), sensitivity, specificity, positive and negative predictive values, and likelihood ratios.SpO(2) of93% was associated with a 30-fold increase in risk (95% CI 14 to 68) of adverse maternal outcome compared to women with SpO(2)97%. After recalibration and extension, the miniPIERS model including SpO(2) (vs. not including SpO(2)) had improved sensitivity (32.8% vs. 49.6%) at the cost of minimally decreased specificity (91.5% vs. 96.2%) with a NRI of 0.122.SpO(2) is a significant independent predictor of risk in women with a HDP. Adding SpO(2) to the miniPIERS model improved the model's ability to correctly identify high-risk patients who would benefit most from interventions. |
| Databáze: | OpenAIRE |
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