Establishing a prediction system for preeclampsia and eclampsia patients

doi:10.3877/cma.j.issn.2095-3259.2013.03.011

Abstract

Abstract:

Objective

To establish a prediction system for preeclampsia and eclampsia patients according to pregnancy physiological and pathological changes.

Methods

A retrospective study was conducted in 437 preeclampsia and eclampsia patients, who were admitted to the intensive care unit of the Third Affiliated Hospital of Guangzhou Medical University from October 1999 to March 2007. Then we analyzed the relationship between scores and the maternal organ dysfunction, and established the prediction scoring system for preeclampsia and eclampsia. The data were analyzed by using Chi-square test and the mortality prediction equation by using logistic regression model.

Results

The prediction system involved 20 clinical indexes, including body temperature, pressure, respiratory rate, heart rate, arterial partial pressure of oxygen, PaO₂/FiO₂, arterial pH value, serum sodium, serum potassium, serum creatinine, ALT, blood platelets count, serum total bilirubin, serum albumin, fibrinogen, white blood count, hematocrit, blood uric acid, age and scores of nervous system. The number of organ dysfunction was increaring with the scores up. The prediction equation for the mortality risk was log eY/(1-Y)=-6.56+ 0.927×scores of nervous system+ 0.149×(total scores-scores of nervous system).

Conclusion

Establishing a prediction system for the preeclampsia and eclampsia patients can evaluate the illness severity better.

Key words: Pre-eclampsia, Severity of illness index, Forecasting, Evaluating severity

Hong-xia ZHANG, Hui-shu LIU, Dun-jin CHEN, Jian-luan KUANG, Xiao-dan DI, Xiao-cun WEI. Establishing a prediction system for preeclampsia and eclampsia patients[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2013, 02(03): 192-197.

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Figures/Tables 4

References 16

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?	参数		0分	1分	2分	3分	4分
1	体温(直肠℃)		36.0～38.5	34.0～36.0	32.0～34.0	30.0～32.0	<30.0
?	?		?	38.5～39.0	?	39.0～41.0	≥41.0
2	血压(mm Hg)	收缩压	90～136	136～150	150～160	160～180	≥180
?	?		?	?	?	?	<90
?	?	或舒张压	60～90	90～100	100～110	110～120	≥120
3	呼吸频率(次/min)		15～25	10～15	6～10	35～50	<6
?	?		?	25～35	?	?	≥50
4	心率(次/min)		70～120	—	120～140	140～180	≥180
?	?		?	?	56～70	40～56	<40
5	氧分压PaO₂(kPa)		≥10.58	9.38～10.58	8.26～9.38	7.34～8.26	<7.34
6	PaO₂/FiO₂(mm Hg)		≥300	225～300	175～225	100～175	<100
7	pH值		7.33～7.50	7.50～7.60	7.25～7.33	7.15～7.25	<7.15
?	?		?	?	?	7.60～7.70	≥7.70
8	钠离子浓度(mmol/L)		130～150	150～155	155～160	160～180	≥180
?	?		?	?	120～130	110～120	<110
9	钾离子浓度(mmol/L)		3.5～5.5	3.0～3.5	2.5～3	6.0～7.0	<2.5
?	?		?	5.5～6	?	?	≥7.0
10	肌酐(μmol/L)		18.75～82.5	—	<18.75	104.99～187.85	≥187.85
?	?		?	?	82.5～104.99	?	?
11	ALT(U/L)		<40	40～120	120～500	≥500	—
12	血小板计数(×10⁹/L)		120～550	50～120	20～50	—	<20
?	?		?	550～1000	≥1000	?	?
13	总胆红素(μmol/L)		<34	34～51	51～85	85～136	≥136
14	白蛋白(g/L)		≥27	21～27	15～21	—	<15
15	纤维蛋白原(g/L)		2.5～6.3	1.6～2.5	1～1.6	0.5～1	<0.5
16	白细胞计数(×10¹²/L)		3～20	—	20～40	—	≥40
?	?		?	?	1～3	?	<1
17	血细胞比容(L/L)		30～39.0	39.0～42.5	17.0～25.5	<17.0	≥51
?	?		?	?	42.5～51.0	?	?
18	血尿酸(μmol/L)		100～350	350～520	≥520	—	—
19	年龄(岁)		18～35	≥35	—	—	—
?	?		?	<18	?	?	?
20	神经系统评分		积分＝15－GCS分值	?	?	?	?

?	参数		0分	1分	2分	3分	4分
1	体温(直肠℃)		36.0～38.5	34.0～36.0	32.0～34.0	30.0～32.0	<30.0
?	?		?	38.5～39.0	?	39.0～41.0	≥41.0
2	血压(mm Hg)	收缩压	90～136	136～150	150～160	160～180	≥180
?	?		?	?	?	?	<90
?	?	或舒张压	60～90	90～100	100～110	110～120	≥120
3	呼吸频率(次/min)		15～25	10～15	6～10	35～50	<6
?	?		?	25～35	?	?	≥50
4	心率(次/min)		70～120	—	120～140	140～180	≥180
?	?		?	?	56～70	40～56	<40
5	氧分压PaO₂(kPa)		≥10.58	9.38～10.58	8.26～9.38	7.34～8.26	<7.34
6	PaO₂/FiO₂(mm Hg)		≥300	225～300	175～225	100～175	<100
7	pH值		7.33～7.50	7.50～7.60	7.25～7.33	7.15～7.25	<7.15
?	?		?	?	?	7.60～7.70	≥7.70
8	钠离子浓度(mmol/L)		130～150	150～155	155～160	160～180	≥180
?	?		?	?	120～130	110～120	<110
9	钾离子浓度(mmol/L)		3.5～5.5	3.0～3.5	2.5～3	6.0～7.0	<2.5
?	?		?	5.5～6	?	?	≥7.0
10	肌酐(μmol/L)		18.75～82.5	—	<18.75	104.99～187.85	≥187.85
?	?		?	?	82.5～104.99	?	?
11	ALT(U/L)		<40	40～120	120～500	≥500	—
12	血小板计数(×10⁹/L)		120～550	50～120	20～50	—	<20
?	?		?	550～1000	≥1000	?	?
13	总胆红素(μmol/L)		<34	34～51	51～85	85～136	≥136
14	白蛋白(g/L)		≥27	21～27	15～21	—	<15
15	纤维蛋白原(g/L)		2.5～6.3	1.6～2.5	1～1.6	0.5～1	<0.5
16	白细胞计数(×10¹²/L)		3～20	—	20～40	—	≥40
?	?		?	?	1～3	?	<1
17	血细胞比容(L/L)		30～39.0	39.0～42.5	17.0～25.5	<17.0	≥51
?	?		?	?	42.5～51.0	?	?
18	血尿酸(μmol/L)		100～350	350～520	≥520	—	—
19	年龄(岁)		18～35	≥35	—	—	—
?	?		?	<18	?	?	?
20	神经系统评分		积分＝15－GCS分值	?	?	?	?

1.睁眼反应	评分	2.语言反应	评分	3.运动反应	评分
自主睁眼	4	语言正常	5	能按指令动作	6
呼唤睁眼	3	言语不当	4	对刺痛能定位	5
刺激睁眼	2	言语错乱	3	对刺痛能躲避	4
不睁眼	1	言语难辨	2	刺痛时肢体过伸	3
?	?	不能言语	1	刺痛时肢体屈曲	2
?	?	?	?	对刺痛无任何反应	1

1.睁眼反应	评分	2.语言反应	评分	3.运动反应	评分
自主睁眼	4	语言正常	5	能按指令动作	6
呼唤睁眼	3	言语不当	4	对刺痛能定位	5
刺激睁眼	2	言语错乱	3	对刺痛能躲避	4
不睁眼	1	言语难辨	2	刺痛时肢体过伸	3
?	?	不能言语	1	刺痛时肢体屈曲	2
?	?	?	?	对刺痛无任何反应	1

评分组	总例数	单器官受损		2器官受损		≥3器官受损
评分组	总例数	例数	百分率(%)	例数	百分率(%)	例数	百分率(%)
2分组	21	0	0	0	0	0	0
3分组	37	5	13.51	0	0	0	0
4分组	51	12	23.53	0	0	0	0
5分组	45	17	37.78	0	0	0	0
6分组	36	14	38.89	2	5.56	0	0
7分组	42	21	50.00	5	11.90	0	0
8分组	26	17	65.38	6	23.08	1	3.85
9分组	29	21	72.41	7	24.14	1	3.45
10分组	25	16	64.00	6	24.00	3	12.00
11分组	19	4	21.05	11	57.89	4	21.05
12分组	14	0	0	6	42.86	7	50.00
13分组	16	0	0	8	50.00	8	50.00
14分组	14	0	0	8	57.14	6	42.86
15分组	13	0	0	7	53.85	6	46.15
16分组	7	0	0	3	42.86	4	57.14
17分组	7	0	0	1	14.29	6	85.71
18分组	7	0	0	1	14.29	6	85.71
19分组	4	0	0	1	25.00	3	75.00
≥20分组	24	0	0	3	12.50	21	87.50
合计	437	127	29.06	75	17.16	76	17.39

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