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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 209 - 219 (11page)
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ObjectiveReviewing indications and characteristics of obstetric patients admitted to the intensive care unit (ICU) of a tertiarycare center, comparing those patients by time period and place of delivery, and to verify clinical utility of acutephysiology and chronic health evaluation (APACHE) II score in ICU-admitted women. MethodsRetrospective analyses were carried out for parturients admitted to the ICU of our institution from 1994 to 2015. Clinical characteristics were compared between time period (period 1: 1994–2004; period 2: 2005–2015) and placeof delivery (our institution and local hospitals). Receiver operating characteristic (ROC) curve analysis was used toevaluate the usefulness of APACHE II score to predict maternal mortality. ResultsDuring 22-year period, 176 women required ICU admission, showing the incidence of 2.2 per 1,000 deliveries. The mostcommon reason for ICU admission was postpartum hemorrhage (56.3%), followed by hypertensive disorders (19.3%),sepsis (3.4%), and pulmonary and amniotic fluid embolism (2.3%). Period 2 showed older maternal age (32.7±4.8 vs. 30.8±4.4 years, P=0.006, higher embolization rate (26.4% vs.1.2%, P<0.001), and lower hysterectomy rate (30.8% vs. 49.4%,P=0.012). Cases from local hospitals showed significantly higher proportion of postpartum hemorrhage (84.5% vs. 42.2%,P<0.001). Overall maternal death occurred in 5.1% (9/176) including 6 direct maternal deaths. The APACHE II score showedarea under the ROC curve of 0.813 (confidence interval [CI], 0.607–1.000) for prediction of maternal mortality. ConclusionThe incidence of obstetric ICU admission was 2.2 per 1,000 deliveries and the most common reason was postpartumhemorrhage followed by hypertensive disorders. APACHE II score could be used to predict mortality in obstetric ICU admission.
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참고문헌 (41)
참고문헌 신청
김호연 / 2014 / 고위험 산모 신생아 통합치료센터 - 진행현황과 문제점: 산과적 측면 / Perinatology 25(3):140~152
서경 / 2004 / 1995년-2000년 한국의 모성사망비 및모성사인의 변화 / Obstetrics & Gynecology Science 47(12)
Collop NA / 1993 / Critical illness in pregnancy. An analysis of 20 patients admitted to a medical intensive care unit / Chest 103:1548~1552
Bouvier-Colle MH / 1997 / Case-control study of risk factors for obstetric patients' admission to intensive care units / Eur J Obstet Gynecol Reprod Biol 74:173~177
Gilbert TT / 2003 / Obstetric admissions to the intensive care unit: outcomes and severity of illness / Obstet Gynecol 102:897~903
서경 / 2004 / 1995년-2000년 한국의 모성사망비 및모성사인의 변화 / Obstetrics & Gynecology Science 47(12)
Collop NA / 1993 / Critical illness in pregnancy. An analysis of 20 patients admitted to a medical intensive care unit / Chest 103:1548~1552
Bouvier-Colle MH / 1997 / Case-control study of risk factors for obstetric patients' admission to intensive care units / Eur J Obstet Gynecol Reprod Biol 74:173~177
Gilbert TT / 2003 / Obstetric admissions to the intensive care unit: outcomes and severity of illness / Obstet Gynecol 102:897~903
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