Performance Characteristics of Sepsis Screening Tools During Antepartum and Postpartum Admissions.
Performance Characteristics of Sepsis Screening Tools During Antepartum and Postpartum Admissions.
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产前和产后入院期间败血症筛查工具的性能特征。
DOI：
10.1097/aog.0000000000005480
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发表时间：
2024
影响因子：
7.2
通讯作者：
Shield
中科院分区：
文献类型：
--
作者：
Bauer,MelissaE;Fuller,Matt;Kovacheva,Vesela;Elkhateb,Rania;Azar,Kristen;Caldwell,Morgan;Chiem,Vanna;Foster,Mindy;Gibbs,Ronald;Hughes,BrennaL;Johnson,Rebecca;Kottukapally,Nobin;Rosenstein,MelissaG;Cortes,MagdalenaSanz;Shield
目的：评估现有筛查工具在产前和产后再入院期间预测脓毒症的性能特点。方法：这是一项病例对照研究，使用 2016 年至 2021 年间从 67 家医院获得的产前脓毒症入院数据和 71 家医院产后 42 天内的再入院数据的电子健康记录数据。脓毒症病例组的患者以 1:4 的比例与产前或产后入院的无脓毒症患者的对照组进行匹配。评估了以下筛查标准：CMQCC（加州孕产妇质量护理协作组织）脓毒症初始筛查、非妊娠调整 SIRS（全身炎症反应综合征）、MEWC（孕产妇早期预警标准）、UKOSS（英国产科监测系统）产科 SIRS 和 MEWT（孕产妇早期预警触发工具）。时间段分为妊娠早期（妊娠20周以下）、妊娠20周以上、产后早期（产后3天以内）、产后晚期至42天。报告了每个总体筛查工具和每个单独标准的假阳性筛查率、C 统计、敏感性和特异性。 结果：
OBJECTIVE:To evaluate the performance characteristics of existing screening tools for the prediction of sepsis during antepartum and postpartum readmissions.METHODS:This was a case–control study using electronic health record data obtained between 2016 and 2021 from 67 hospitals for antepartum sepsis admissions and 71 hospitals for postpartum readmissions up to 42 days. Patients in the sepsis case group were matched in a 1: 4 ratio to a comparison cohort of patients without sepsis admitted antepartum or postpartum. The following screening criteria were evaluated: the CMQCC (California Maternal Quality Care Collaborative) initial sepsis screen, the non–pregnancy-adjusted SIRS (Systemic Inflammatory Response Syndrome), the MEWC (Maternal Early Warning Criteria), UKOSS (United Kingdom Obstetric Surveillance System) obstetric SIRS, and the MEWT (Maternal Early Warning Trigger Tool). Time periods were divided into early pregnancy (less than 20 weeks of gestation), more than 20 weeks of gestation, early postpartum (less than 3 days postpartum), and late postpartum through 42 days. False-positive screening rates, C-statistics, sensitivity, and specificity were reported for each overall screening tool and each individual criterion.RESULTS: