Abstract：
OBJECTIVE: Hemorrhage risk assessment tools have been studied using estimated blood loss. We study the association between peripartum hemorrhage risk assessment score and peripartum quantified blood loss (QBL) in term vaginal and cesarean deliveries.
METHODS: This is a retrospective analysis conducted on 3,657 patients who underwent term vaginal and cesarean deliveries at a public hospital in New York City. Utilizing the risk assessment tool developed by the Association of Women\'s Health, Obstetric and Neonatal Nurses (AWHONN), patients were categorized into low-, medium-, or high-risk groups for postpartum hemorrhage.
RESULTS: Medium-risk (B=0.08, SE=0.01, p<0.001) and high-risk (B=0.12, SE=0.02, p<0.001) AWHONN scores were associated with significantly higher QBL as compared to low-risk AWHONN score. Medium-risk approached significance (OR: 1.67, 95 % CI: 1.00, 2.79, p=0.050) and high-risk AWHONN score was significantly associated (OR: 1.95, 95 % CI: 1.09, 3.48, p=0.02) with increased odds for postpartum hemorrhage (≥1,000 mL). Each individual factor comprising the AWHONN score whose percentage in our sample was seen in greater than 2.7 % of patients was independently significantly associated with increased QBL (six of nine factors) and postpartum hemorrhage (four of nine factors).
CONCLUSIONS: The AWHONN measure previously validated with estimated blood loss predicted obstetric blood loss with QBL. Although not on the basis of the data shown in our study, we believe that QBL should be routinely used to measure obstetric blood loss.
METHODS: This is a retrospective analysis conducted on 3,657 patients who underwent term vaginal and cesarean deliveries at a public hospital in New York City. Utilizing the risk assessment tool developed by the Association of Women\'s Health, Obstetric and Neonatal Nurses (AWHONN), patients were categorized into low-, medium-, or high-risk groups for postpartum hemorrhage.
RESULTS: Medium-risk (B=0.08, SE=0.01, p<0.001) and high-risk (B=0.12, SE=0.02, p<0.001) AWHONN scores were associated with significantly higher QBL as compared to low-risk AWHONN score. Medium-risk approached significance (OR: 1.67, 95 % CI: 1.00, 2.79, p=0.050) and high-risk AWHONN score was significantly associated (OR: 1.95, 95 % CI: 1.09, 3.48, p=0.02) with increased odds for postpartum hemorrhage (≥1,000 mL). Each individual factor comprising the AWHONN score whose percentage in our sample was seen in greater than 2.7 % of patients was independently significantly associated with increased QBL (six of nine factors) and postpartum hemorrhage (four of nine factors).
CONCLUSIONS: The AWHONN measure previously validated with estimated blood loss predicted obstetric blood loss with QBL. Although not on the basis of the data shown in our study, we believe that QBL should be routinely used to measure obstetric blood loss.
摘要：
目的：已经使用估计的失血量研究了出血风险评估工具。我们研究了足月阴道分娩和剖宫产中围产期出血风险评估评分与围产期量化失血（QBL）之间的关系。
方法：这是一项对3,657名在纽约市一家公立医院接受足月阴道分娩和剖宫产分娩的患者进行的回顾性分析。利用妇女健康协会开发的风险评估工具，产科和新生儿护士（AWHONN），患者被分类为低，medium-,或产后出血的高危人群。
结果：中风险（B=0.08，SE=0.01，p<0.001）和高风险（B=0.12，SE=0.02，p<0.001）AWHONN评分与QBL显著高于低风险AWHONN评分相关。中等风险接近显着性（OR：1.67，95％CI：1.00，2.79，p=0.050），高危AFHONN评分（OR：1.95，95％CI：1.09，3.48，p=0.02）与产后出血几率增加（≥1,000mL）显著相关。在我们的样本中超过2.7％的患者中，包含AWHONN评分的每个单独因素与QBL增加（9个因素中的6个）和产后出血（9个因素中的4个）独立显着相关。
结论：先前通过估计失血量验证的AWHONN测量值预测了QBL的产科失血量。尽管不是根据我们研究中显示的数据，我们认为应常规使用QBL来测量产科失血量.
方法：这是一项对3,657名在纽约市一家公立医院接受足月阴道分娩和剖宫产分娩的患者进行的回顾性分析。利用妇女健康协会开发的风险评估工具，产科和新生儿护士（AWHONN），患者被分类为低，medium-,或产后出血的高危人群。
结果：中风险（B=0.08，SE=0.01，p<0.001）和高风险（B=0.12，SE=0.02，p<0.001）AWHONN评分与QBL显著高于低风险AWHONN评分相关。中等风险接近显着性（OR：1.67，95％CI：1.00，2.79，p=0.050），高危AFHONN评分（OR：1.95，95％CI：1.09，3.48，p=0.02）与产后出血几率增加（≥1,000mL）显著相关。在我们的样本中超过2.7％的患者中，包含AWHONN评分的每个单独因素与QBL增加（9个因素中的6个）和产后出血（9个因素中的4个）独立显着相关。
结论：先前通过估计失血量验证的AWHONN测量值预测了QBL的产科失血量。尽管不是根据我们研究中显示的数据，我们认为应常规使用QBL来测量产科失血量.
