One Year Cross-Sectional Study of the Critically Ill Obstetric Patients Requiring Intensive Care Unit Admissions and Predicting Mortality by Using Simplified Acute Physiology Score II

Abstract

Background and Objectives ABSTRACT Despite progress in medical field and improvement in health facilities provided, maternal mortality is still very high in most of the developing countries. Objectives of the present study were to describe illness characteristics of a large cohort of obstetric patients admitted to the ICU and to determine whether mortality prediction was accurate with use of the SAPS II model. Methods The present cross sectional study was conducted in Department of Medicine, at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2008 to December 2008 on 41 patients. Critically ill obstetric patients requiring ICU admissions were studied for clinical picture, diagnosis, demographic profile and mortality. SAPS II score was calculated according to the different variables for predicting mortality. Results Majority of the patients were between 20 to 25 years of age ( 56.09% ) and primigravida ( 58.54% ) . In obstetric disorders, PIH and Puerperal sepsis were the commonest indications for ICU admission, being present in nine patients ( 21.95% ) and seven patients ( 21.95% ) respectively. In medical disorders most common cause for ICU admission was CVT in 10 patients ( 24.39% ) that is, nine post partum CVT and one antepartum CVT followed by heart disease in three patients ( 7.31% ) . Mean SAPS II score for expired patients was higher, viz., 57.1 ± 13.67 ( range 40-79) , compared to that of survivors, which was 28.5 ± 12.63 IX ( range 12-56) . The predictability of mortality by SAPS II model was statistically significant ( p=0.000 ) . Conclusion The SAPS II model is a good predictor of mortality in obstetric patients admitted for medical reasons, but slightly over-predicted the mortality rate in obstetric patients admitted for only obstetric reasons. Computation of the score as a routine in ICU may help in identifying those at high risk of mortality and then to reduce this risk.