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Research article
Alcade RUDAKEMWA
Ruhengeri referral hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5945-6761
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Reasons for obstetric admission in intensive care unit (ICU) vary from a setting to another. Outcomes from ICU and its prediction models are not well explored in Rwanda because of lack of appropriate scores. This study intended to assess profile and accuracy of predictive models for obstetric patients admitted in ICU in the two public tertiary hospitals in Rwanda.
Methods
We prospectively collected data from all obstetric patients admitted in the ICU of public referral hospitals in Rwanda from March 2017 to February 2018 to identify reasons for admissions and factors for prognosis. We analysed the accuracy of mortality prediction by the quick Sequential Organ Failure Assessment (qSOFA) and Modified Early Obstetric Warning Score (MEOWS).
Results
Obstetric patients represented 12.8% of all ICU admissions and 1.8% of all deliveries. Sepsis (31.9%) and haemorrhage (25.5%) were the two commonest reasons of admission. Mortality was 54.3% while the average length of stay was 6.6 days. MEOWS was an independent predictor to mortality (adjusted OR=1.25[1.07-1.46]; p=0.005). Similarly, one point of increase of the qSOFA increased odds of ICU mortality by 181% (adjusted OR=2.81[1.25-6.30]; p=0.012). The Area Under the Receiver Operating Characteristic Curve (AUROC) for MEOWS was 0.773[0.666-0.880], p=0.0001 and that of the qSOFA was 0.764[0.654-0.873]; p=0.0001.
Conclusion
Sepsis is the most common reason for obstetric admissions to ICU in Rwanda. MEOWS and qSOFA could accurately predict the mortality for those patients but further explorations on a larger sample size are guaranteed.
Keywords
Obstetric, intensive care unit, critical care, mortality prediction
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CURRENT STATUS: Under Review
The most recent version of this article is available here.
No community comments so far
Editorial decision: Major revision
On 29 Jan, 2021
Editor assigned
On 13 Dec, 2020
Submission checks complete
On 13 Dec, 2020
Editor invited
On 13 Dec, 2020
Version 1
Posted 29 May, 2020
No comments provided
Editorial decision: Major revision
On 14 Nov, 2020
Reviewer #2 agreed
On 08 Jul, 2020
Review #1 received
Received 12 Jun, 2020
Reviewers invited
Invitations sent on 11 Jun, 2020
Reviewer #1 agreed
On 11 Jun, 2020
Editor assigned
On 25 May, 2020
Submission checks complete
On 24 May, 2020
Editor invited
On 24 May, 2020
First submitted
On 23 May, 2020
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Subject Areas
Maternal & Fetal Medicine
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at BMC Pregnancy and Childbirth. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Alcade RUDAKEMWA
Ruhengeri referral hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5945-6761
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
The most recent version of this article is available here.
No community comments so far
Editorial decision: Major revision
On 29 Jan, 2021
Editor assigned
On 13 Dec, 2020
Submission checks complete
On 13 Dec, 2020
Editor invited
On 13 Dec, 2020
Version 1
Posted 29 May, 2020
No comments provided
Editorial decision: Major revision
On 14 Nov, 2020
Reviewer #2 agreed
On 08 Jul, 2020
Review #1 received
Received 12 Jun, 2020
Reviewers invited
Invitations sent on 11 Jun, 2020
Reviewer #1 agreed
On 11 Jun, 2020
Editor assigned
On 25 May, 2020
Submission checks complete
On 24 May, 2020
Editor invited
On 24 May, 2020
First submitted
On 23 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
Background
Reasons for obstetric admission in intensive care unit (ICU) vary from a setting to another. Outcomes from ICU and its prediction models are not well explored in Rwanda because of lack of appropriate scores. This study intended to assess profile and accuracy of predictive models for obstetric patients admitted in ICU in the two public tertiary hospitals in Rwanda.
Methods
We prospectively collected data from all obstetric patients admitted in the ICU of public referral hospitals in Rwanda from March 2017 to February 2018 to identify reasons for admissions and factors for prognosis. We analysed the accuracy of mortality prediction by the quick Sequential Organ Failure Assessment (qSOFA) and Modified Early Obstetric Warning Score (MEOWS).
Results
Obstetric patients represented 12.8% of all ICU admissions and 1.8% of all deliveries. Sepsis (31.9%) and haemorrhage (25.5%) were the two commonest reasons of admission. Mortality was 54.3% while the average length of stay was 6.6 days. MEOWS was an independent predictor to mortality (adjusted OR=1.25[1.07-1.46]; p=0.005). Similarly, one point of increase of the qSOFA increased odds of ICU mortality by 181% (adjusted OR=2.81[1.25-6.30]; p=0.012). The Area Under the Receiver Operating Characteristic Curve (AUROC) for MEOWS was 0.773[0.666-0.880], p=0.0001 and that of the qSOFA was 0.764[0.654-0.873]; p=0.0001.
Conclusion
Sepsis is the most common reason for obstetric admissions to ICU in Rwanda. MEOWS and qSOFA could accurately predict the mortality for those patients but further explorations on a larger sample size are guaranteed.
Figure 1
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