Key result
Simple scoring model predicts mechanical ventilation need in preeclampsia with an AUC of ~0.86.
Why the study?
What are the risk factors and predictors for mechanical ventilation in patients with preeclampsia complicated by pulmonary edema?
Case-Control (n=1,106)
No
What are the risk factors and predictors for mechanical ventilation in patients with preeclampsia complicated by pulmonary edema?
A newly developed scoring model can accurately predict the need for mechanical ventilation in patients with preeclampsia complicated by pulmonary edema.
Answers are grounded in this paper and cite their sources.
May inform ventilation risk stratification in preeclampsia; hypothesis-generating and requires prospective validation before clinical use.
OBJECTIVE: To analyze risk factors, obstetric outcome and the need for mechanical ventilation in preeclampsia complicated by pulmonary edema. MATERIALS AND METHODS: Case-control study using medical record on preeclampsia complicated by pulmonary edema patients in East Java tertiary referral hospital over 2 years. A simple scoring system was developed to predict the need for mechanical ventilation, using logistic regression. RESULTS: 1106 cases of preeclampsia were admitted, with 62 cases (5.6%) had pulmonary edema. Postpartum (p < .001) and cesarean delivery (p = .001) proportions were higher in the preeclampsia with pulmonary edema group. Of the 62 cases with pulmonary edema, 81% required intensive care admission and 60% needed mechanical ventilation support. Mechanical ventilation used was associated with eclampsia (p = .04), hypertensive crisis (p = .02), lower serum albumin (p = .05) and higher creatinine (p = .01). A simple scoring model developed could predict a 46%-99% probability of need for mechanical ventilation (AUC (ROC): 0.856, 95%CI 0.763-0.95). CONCLUSIONS: Pulmonary edema is a common complication of preeclampsia in Indonesian referral hospitals. This severe complication increased maternal and perinatal morbidity and mortality. The developed scoring model in this study can be used as a triage tool to predict the probability of mechanical ventilation use due to this complication.
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Wardhana et al. (2017) conducted a case-control in Preeclampsia (n=1,106). Pulmonary edema vs. Preeclampsia without pulmonary edema was evaluated on Prediction of need for mechanical ventilation using a simple scoring model (AUC 0.856, 95% CI 0.763-0.95). In patients with preeclampsia, pulmonary edema occurred in 5.6% of cases, and a developed scoring model predicted the need for mechanical ventilation with an AUC of 0.856.
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