Assessment of the Clinical Profiles of the Obstetric Patients Admitted to ICU in a Tertiary Care Hospital, Madhya Pradesh, India: A Longitudinal Study

Abstract

Introduction: Management of critically ill obstetric population admitted to Intensive Care Unit (ICU) remains a significant hurdle in developing countries. Aim: To examine demographic characteristics, diagnoses, clinical outcomes, and performance of modified Sequential Organ Failure Assessment (SOFA) score between survivors and non survivors in all obstetric admissions to the ICU. Materials and Methods: This was a longitudinal study conducted in a 12-bedded obstetric ICU at 850 bedded Netaji Subhash Chandra Bose Medical College, Madhya Pradesh, India from March 2016 to August 2017. Clinical profile and outcomes of ICU patients were analysed for total 367 obstetric ICU admission. To determine mortality outcomes of the study population, a modified SOFA score was used to take into account physiological changes in pregnancy. All statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 15.0 (Inc., Chicago, Illinois, USA). Receiver Operating Characteristics (ROC) curve analyses of SOFA score as a predictor of mortality, and optimum cutoff point value was determined. Results: The mean age of the study population was 24.7±4.0 years. Eclampsia (35.7%) and preeclampsia (13.62%) were the leading indications of admission. The survival of patients was associated significantly with low SOFA scores with mean SOFA score of 6.48±2.804 among survivors and 10.42±3.579 among non survivors (p-value=0.001). Conclusion: Eclampsia and preeclampsia were the leading cause of ICU admission, that can be preventable. Higher SOFA score was related to higher mortality in the obstetric patients requiring ICU.