Validation of an obstetric comorbidity index in an external population
Validation of an obstetric comorbidity index in an external population
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DOI：
10.1111/1471-0528.13254
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发表时间：
2015-12-01
影响因子：
5.8
通讯作者：
Tough, S. C.
中科院分区：
文献类型：
--
作者：
Metcalfe, A.;Lix, L. M.;Tough, S. C.
目的：产科合并症指数最近已发展成为一个具有上级性能特点，相对于一般合并症的措施，在产科人口。本研究的目的是外部验证这个指数，并检查包括住院/分娩记录的影响，只有当估计合并症的患病率和产科合并症index.DesignValidation研究的歧视性表现SettingAlberta，加拿大PopulationPregnant women who delivered a live or stillborn infant in hospital（n=5995）.MethodsAdministrative databases were linked to create a population-based cohort.从妊娠期间和妊娠前3个月发生的分娩住院、所有住院和所有医疗保健联系（即住院、急诊室访视和医生访视）的诊断中确定共病疾病。Logistic回归被用来测试comorbidity index.Main outcome measuresMaternal end-organ damage and extended length of stay for delivery.ResultsAlthough患病率估计共病的条件是一贯低于分娩记录和住院数据比在所有的医疗保健接触的数据，合并症指数对母体终末器官损伤的区分性能是恒定的[所有医疗保健接触者的受试者工作特征曲线下面积（AUC）= 0.70;住院数据AUC=0.67;分娩数据AUC=0.65]和延长的分娩住院时间（所有医疗保健联系人AUC=0.60;住院数据AUC = 0.58;分娩数据AUC=0.58）。此外，对于分娩时、住院数据中或通过所有医疗保健联系人确定的合并症，合并症指数的区分性能相似。
ObjectivesAn obstetric comorbidity index has been developed recently with superior performance characteristics relative to general comorbidity measures in an obstetric population. This study aimed to externally validate this index and to examine the impact of including hospitalisation/delivery records only when estimating comorbidity prevalence and discriminative performance of the obstetric comorbidity index.DesignValidation study.SettingAlberta, Canada.PopulationPregnant women who delivered a live or stillborn infant in hospital (n=5995).MethodsAdministrative databases were linked to create a population-based cohort. Comorbid conditions were identified from diagnoses for the delivery hospitalisation, all hospitalisations and all healthcare contacts (i.e. hospitalisations, emergency room visits and physician visits) that occurred during pregnancy and 3months pre-conception. Logistic regression was used to test the discriminative performance of the comorbidity index.Main outcome measuresMaternal end-organ damage and extended length of stay for delivery.ResultsAlthough prevalence estimates for comorbid conditions were consistently lower in delivery records and hospitalisation data than in data for all healthcare contacts, the discriminative performance of the comorbidity index was constant for maternal end-organ damage [all healthcare contacts area under the receiver operating characteristic curve (AUC)=0.70; hospitalisation data AUC=0.67; delivery data AUC=0.65] and extended length of stay for delivery (all healthcare contacts AUC=0.60; hospitalisation data AUC=0.58; delivery data AUC=0.58).ConclusionsThe obstetric comorbidity index shows similar performance characteristics in an external population and is a valid measure of comorbidity in an obstetric population. Furthermore, the discriminative performance of the comorbidity index was similar for comorbidities ascertained at the time of delivery, in hospitalisation data or through all healthcare contacts.