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Characterization of obstetric patients with sepsis identified by two diagnostic scales at a fourth‐level clinic in Colombia
Author(s) -
Escobar María F.,
Nasner Daniela,
Hurtado Carlos F.,
Fernández Paula A.,
Echavarria Maria P.
Publication year - 2018
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.12580
Subject(s) - medicine , concordance , systemic inflammatory response syndrome , sofa score , sepsis , intensive care unit , population , observational study , retrospective cohort study , emergency medicine , pediatrics , environmental health
Objective To compare the characterization of an obstetric population diagnosed with sepsis using systemic inflammatory response syndrome ( SIRS ) criteria and sepsis‐related organ failure assessment ( SOFA ). Methods The present retrospective observational descriptive study was conducted at a fourth‐level clinic in Colombia among pregnant women who met the inclusion criteria (two SIRS criteria plus infection) between January 1, 2015, and December 31, 2016. Patients with systemic compromise were admitted to the high‐complexity obstetric unit ( HCOU ), whereas those with multiorgan dysfunction were admitted to the intensive care unit ( ICU ). The SIRS scale was deemed positive if all four criteria were met. A SOFA score of at least 2 was considered a positive result. Results The study included 688 patients. The SIRS test at admission was positive among 431 patients (62.6%); 279 (64.7%) in the HCOU group and 152 (35.2%) in the ICU group. The SOFA test at admission was positive in 69 (38.5%) of 179 patients with complete data. The concordance—measured using the κ statistic—between SIRS and SOFA was low (0.016). Conclusion Using the SIRS scale could promote early sepsis management by identifying patients who require admission to the HCOU or ICU ; however, low concordance between the SIRS and SOFA results suggested a need to create diagnostic scales specifically for the obstetric population.