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Validation of full PIERS model for prediction of adverse outcomes among women with severe pre‐eclampsia
Author(s) -
Almeida Silvana T.,
Katz Leila,
Coutinho Isabela,
Amorim Melania M.R.
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12197
Subject(s) - medicine , confidence interval , receiver operating characteristic , eclampsia , odds ratio , cutoff , logistic regression , area under the curve , statistics , obstetrics , likelihood ratios in diagnostic testing , multivariate analysis , pregnancy , mathematics , genetics , physics , quantum mechanics , biology
Objective To evaluate the accuracy of the Pre‐eclampsia Integrated Estimate of RiSk (full PIERS ) model for the prediction of complications among patients with severe pre‐eclampsia in northeastern Brazil. Methods A retrospective study was conducted of data for all patients with severe pre‐eclampsia admitted to a center in Recife in 2014. The full PIERS model was applied to calculate the predicted probability of complications. A receiver operating characteristic curve was constructed to determine the accuracy of the model, and the area under the curve was calculated. Multiple logistic regression analysis was performed. Results Among 325 included women, 55 (16.9%) had one or more complication before discharge. The area under the curve was 0.72 ( P <0.001), determining a cutoff point for full PIERS probability of 1.7%. Sensitivity was 60.0% and specificity was 65.1%; the positive likelihood ratio was 1.72 and the negative likelihood ratio was 0.61. In multivariate analysis, the only variable that remained significantly associated with complications was a full PIERS probability of more than 1.7% (odds ratio 5.87, 95% confidence interval 3.16–10.89; P <0.001). Conclusion The full PIERS model is a useful tool for predicting complications in women with severe pre‐eclampsia, with the cutoff point of 1.7%.