Abstract：
OBJECTIVE: To validate the accuracy of four early warning scores for early identification of women at risk.
METHODS: This was a retrospective study of pregnant women admitted in obstetrics Critical Care Unit (ICU). Capacity of the Modified Obstetric Early Warning Score (MOEWS), ICNARC Obstetric Early Warning Score (OEWS), Maternal Early Obstetric Warning System (MEOWS chart), and Maternal Early Warning Trigger (MEWT) were compared in predicting severe maternal morbidity. Area under receiver operator characteristic (AUROC) curve was used to evaluate the predictive performance of scoring system.
RESULTS: A total of 352 pregnant women were enrolled and 290 were identified with severe maternal morbidity. MOEWS was more sensitive than MEOWS chart, ICNARC OEWS and MEWT (96.9 % vs. 83.4 %, 66.6 % and 44.8 %). MEWT had the highest specificity (98.4 %), followed by MOEWS (83.9 %), ICNARC OEWS (75.8 %) and MEOWS chart (48.4 %). AUROC of MOEWS, ICNARC OEWS, MEOWS chart, and MEWT for prediction of maternal mortality were 0.91 (95 % CI: 0.874-0.945), 0.765(95 % CI: 0.71-0.82), 0.657(95 % CI: 0.577-0.738), and 0.716 (95 % CI, 0.659-0.773) respectively. MOEWS had the highest AUCs in the discrimination of serious complications in hypertensive disorders, cardiovascular disease, obstetric hemorrhage and infection. For individual vital signs, maximum diastolic blood pressure (DBP), maximum systolic blood pressure (SBP), maximum respiratory rate (RR) and peripheral oxygen saturation (SPO2) demonstrated greater predictive ability.
CONCLUSIONS: MOEWS is more accurate than ICNARC OEWS, MEOWS chart, and MEWT in predicting the deterioration of women. The prediction ability of DBP, SBP, RR and SPO2 are more reliable.
METHODS: This was a retrospective study of pregnant women admitted in obstetrics Critical Care Unit (ICU). Capacity of the Modified Obstetric Early Warning Score (MOEWS), ICNARC Obstetric Early Warning Score (OEWS), Maternal Early Obstetric Warning System (MEOWS chart), and Maternal Early Warning Trigger (MEWT) were compared in predicting severe maternal morbidity. Area under receiver operator characteristic (AUROC) curve was used to evaluate the predictive performance of scoring system.
RESULTS: A total of 352 pregnant women were enrolled and 290 were identified with severe maternal morbidity. MOEWS was more sensitive than MEOWS chart, ICNARC OEWS and MEWT (96.9 % vs. 83.4 %, 66.6 % and 44.8 %). MEWT had the highest specificity (98.4 %), followed by MOEWS (83.9 %), ICNARC OEWS (75.8 %) and MEOWS chart (48.4 %). AUROC of MOEWS, ICNARC OEWS, MEOWS chart, and MEWT for prediction of maternal mortality were 0.91 (95 % CI: 0.874-0.945), 0.765(95 % CI: 0.71-0.82), 0.657(95 % CI: 0.577-0.738), and 0.716 (95 % CI, 0.659-0.773) respectively. MOEWS had the highest AUCs in the discrimination of serious complications in hypertensive disorders, cardiovascular disease, obstetric hemorrhage and infection. For individual vital signs, maximum diastolic blood pressure (DBP), maximum systolic blood pressure (SBP), maximum respiratory rate (RR) and peripheral oxygen saturation (SPO2) demonstrated greater predictive ability.
CONCLUSIONS: MOEWS is more accurate than ICNARC OEWS, MEOWS chart, and MEWT in predicting the deterioration of women. The prediction ability of DBP, SBP, RR and SPO2 are more reliable.
摘要：
目的：验证四个早期预警评分对早期识别高危女性的准确性。
方法：这是一项对产科重症监护病房（ICU）收治的孕妇的回顾性研究。改良产科预警评分（MOEWS）的容量，ICNARC产科预警评分（OEWS），产妇早期产科预警系统（MEOWS图表），和产妇早期预警触发（MEWT）在预测严重产妇发病率方面进行了比较。使用受试者操作特征下面积（AUROC）曲线评估评分系统的预测性能。
结果：共纳入352名孕妇，290名孕妇被确定为严重的孕产妇发病率。MOEWS比MEOWS图表更敏感，ICNARCOEWS和MEWT（96.9%与83.4%,66.6%和44.8%）。MEWT的特异性最高(98.4%)，其次是MOEWS(83.9%)，ICNARCOEWS（75.8%）和MEOWS图表（48.4%）。MOEWS的AUROC,ICNARCOEWS,MEOWS图表,和MEWT预测孕产妇死亡率为0.91（95％CI：0.874-0.945），0.765（95%CI：0.71-0.82），0.657（95%CI：0.577-0.738），和0.716（95%CI，0.659-0.773）。在区分高血压疾病的严重并发症方面，MOEWS的AUC最高，心血管疾病,产科出血和感染。对于个体生命体征，最大舒张压（DBP），最大收缩压（SBP），最大呼吸频率（RR）和外周血氧饱和度（SPO2）显示出更高的预测能力。
结论：MOEWS比ICNARCOEWS更准确，MEOWS图表,和MEWT预测妇女的恶化。DBP的预测能力，SBP,RR和SPO2更可靠。
方法：这是一项对产科重症监护病房（ICU）收治的孕妇的回顾性研究。改良产科预警评分（MOEWS）的容量，ICNARC产科预警评分（OEWS），产妇早期产科预警系统（MEOWS图表），和产妇早期预警触发（MEWT）在预测严重产妇发病率方面进行了比较。使用受试者操作特征下面积（AUROC）曲线评估评分系统的预测性能。
结果：共纳入352名孕妇，290名孕妇被确定为严重的孕产妇发病率。MOEWS比MEOWS图表更敏感，ICNARCOEWS和MEWT（96.9%与83.4%,66.6%和44.8%）。MEWT的特异性最高(98.4%)，其次是MOEWS(83.9%)，ICNARCOEWS（75.8%）和MEOWS图表（48.4%）。MOEWS的AUROC,ICNARCOEWS,MEOWS图表,和MEWT预测孕产妇死亡率为0.91（95％CI：0.874-0.945），0.765（95%CI：0.71-0.82），0.657（95%CI：0.577-0.738），和0.716（95%CI，0.659-0.773）。在区分高血压疾病的严重并发症方面，MOEWS的AUC最高，心血管疾病,产科出血和感染。对于个体生命体征，最大舒张压（DBP），最大收缩压（SBP），最大呼吸频率（RR）和外周血氧饱和度（SPO2）显示出更高的预测能力。
结论：MOEWS比ICNARCOEWS更准确，MEOWS图表,和MEWT预测妇女的恶化。DBP的预测能力，SBP,RR和SPO2更可靠。
