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Medical emergency team may reduce obstetric intensive care unit admissions
Author(s) -
Baek Moon Seong,
Son Jeongsuk,
Huh Jin Won,
Lim ChaeMan,
Koh Younsuck,
Won HyeSung,
Shim JaeYoon,
Hong SangBum
Publication year - 2017
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13177
Subject(s) - medicine , intensive care unit , critically ill , emergency medicine , early warning score , septic shock , shock (circulatory) , intensive care medicine , sepsis
Aim Some recent studies have reported that early intervention by a medical emergency team (MET) for clinical deterioration before intensive care unit (ICU) admission was associated with a survival benefit in critically ill cancer patients. We hypothesized that early MET intervention for an obstetric crisis in the general wards would be related to favorable outcomes in critically ill obstetric patients. Methods Data of obstetric patients who were managed by a MET were collected retrospectively from 1 March 2008 to 30 April 2015. A total of 69 obstetric patients were enrolled. Among them, 48 (69.6%) were treated successfully in the general wards and 21 (30.4%) were transferred to the ICU. Results Major causes of MET activation were pulmonary edema ( n = 23, 33.3%), hypovolemic shock ( n = 19, 27.5%), and septic shock ( n = 8, 11.6%). Compared with the patients treated in the general ward, the patients transferred to the ICU had significantly higher severity of illness score. Sequential Organ Failure Assessment score was the most useful for prediction of ICU admission of obstetric patients (AUC, 0.810, P < 0.001), and the ideal cut‐off was 4 (sensitivity, 81%; specificity, 60%). During the study period, in‐hospital mortality of the obstetric patients was 2.9% (2/69). Conclusion After MET activation many obstetric patients could be successfully treated in the general wards without mortality. Therefore, MET may reduce ICU admissions in critically ill obstetric patients.