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Assessing the incremental value of blood oxygen saturation (SpO(2)) in the miniPIERS (Pre-eclampsia Integrated Estimate of RiSk) Risk Prediction Model.

Payne, BA; Hutcheon, JA; Dunsmuir, D; Cloete, G; Dumont, G; Hall, D; Lim, J; Magee, LA; Sikandar, R; Qureshi, R; et al. Payne, BA; Hutcheon, JA; Dunsmuir, D; Cloete, G; Dumont, G; Hall, D; Lim, J; Magee, LA; Sikandar, R; Qureshi, R; van Papendorp, E; Ansermino, JM; von Dadelszen, P (2015) Assessing the incremental value of blood oxygen saturation (SpO(2)) in the miniPIERS (Pre-eclampsia Integrated Estimate of RiSk) Risk Prediction Model. Journal of Obstetrics and Gynaecology Canada, 37 (1). pp. 16-24. ISSN 1701-2163 https://doi.org/10.1016/S1701-2163(15)30358-3
SGUL Authors: von Dadelszen, Peter

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Abstract

OBJECTIVE: To assess the incremental value of blood oxygen saturation (SpO(2)) as a predictor in the miniPIERS model, a risk prediction model for adverse outcomes among women with a diagnosis of hypertensive disorder of pregnancy (HDP) in low-resourced settings. METHODS: Using data from a prospective cohort including 852 women admitted to hospital for a HDP, the association between SpO(2) and adverse maternal outcome was assessed using logistic regression. The miniPIERS model was recalibrated and extended to include SpO(2). The incremental value of adding SpO(2) to the model was measured using a net reclassification index (NRI), sensitivity, specificity, positive and negative predictive values, and likelihood ratios. RESULTS: SpO(2) of < 93% was associated with a 30-fold increase in risk (95% CI 14 to 68) of adverse maternal outcome compared to women with SpO(2) > 97%. After recalibration and extension, the miniPIERS model including SpO(2) (vs. not including SpO(2)) had improved sensitivity (32.8% vs. 49.6%) at the cost of minimally decreased specificity (91.5% vs. 96.2%) with a NRI of 0.122. CONCLUSION: SpO(2) is a significant independent predictor of risk in women with a HDP. Adding SpO(2) to the miniPIERS model improved the model's ability to correctly identify high-risk patients who would benefit most from interventions.

Item Type: Article
Additional Information: © 2015 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved. Made available with permission from the publisher. Contact publisher for any further re-use.
Keywords: preeclampsia, prognosis, pulse oximetry, recalibration, Adult, Blood Gas Monitoring, Transcutaneous, Female, Humans, Oxygen, Pre-Eclampsia, Pregnancy, Prospective Studies, Risk Assessment, Young Adult, Humans, Pre-Eclampsia, Oxygen, Blood Gas Monitoring, Transcutaneous, Risk Assessment, Prospective Studies, Pregnancy, Adult, Female, Young Adult, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Journal of Obstetrics and Gynaecology Canada
ISSN: 1701-2163
Language: eng
Dates:
DateEvent
1 January 2015Published
Publisher License: Publisher's own licence
PubMed ID: 25764032
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107513
Publisher's version: https://doi.org/10.1016/S1701-2163(15)30358-3

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