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首页> 外文期刊>Journal of Clinical Medicine Research >Patterns of the Demographics, Clinical Characteristics, and Resource Utilization Among Maternal Decedents in Texas, 2001 - 2010: A Population-Based Cohort Study
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Patterns of the Demographics, Clinical Characteristics, and Resource Utilization Among Maternal Decedents in Texas, 2001 - 2010: A Population-Based Cohort Study

机译：2001-2010年德克萨斯州孕妇后代的人口统计学特征，临床特征和资源利用模式：基于人群的队列研究

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Background: Contemporary reporting of maternal mortality is focused on single, mutually exclusive causes of death among a minority of maternal decedents (pregnancy-related deaths), reflecting initial events leading to death. Although obstetric patients are susceptible to the lethal effects of downstream, more proximate contributors to death and to conditions not caused or precipitated by pregnancy, the burden of both categories and related patients’ attributes is invisible to clinicians and healthcare policy makers with the current reporting system. Thus, the population-level demographics, clinical characteristics, and resource utilization associated with pregnancy-associated deaths in the United States have not been adequately characterized.Methods: We used the Texas Inpatient Public Use Data File to perform a population-based cohort study of the patterns of demographics, chronic comorbidity, occurrence of early maternal demise, potential contributors to maternal death, and resource utilization among maternal decedents in the state during 2001 - 2010.Results: There were 557 maternal decedents during study period. Chronic comorbidity was reported in 45.2%. Most women (74.1%) were admitted to an ICU. Hemorrhage (27.8%), sepsis (23.5%), and cardiovascular conditions (22.6%) were the most commonly reported potential contributing conditions to maternal death, varying across categories of pregnancy-associated hospitalizations. More than one condition was reported in 39% of decedents. One in three women died during their first day of hospitalization, with no significant change over the past decade. The mean hospital length of stay was 7.9 days and total hospital charges were $250,000 or higher in 65 (11.7%) women.Conclusions: The findings of the high burden of chronic illness, patterns of occurrence of a broad array of potential contributing conditions to pregnancy-associated death, and the resource-intensive needs of a large contemporary population-based cohort of maternal decedents may better inform preventive and intervention measures at the bedside and as healthcare policy priorities. The prevalent and unchanged occurrence of rapid maternal demise following presentation for hospitalization supports a special focus on means to identify and effectively address front-line clinician- and healthcare system-related performance areas that can improve maternal outcomes. The common reporting of more than one potential contributing condition underscores the complexity of determination of causes of maternal death.J Clin Med Res. 2015;7(12):937-946doi: http://dx.doi.org/10.14740/jocmr2338w
机译：背景：当代的孕产妇死亡报告主要集中在少数孕产妇死亡（与怀孕有关的死亡）中的单一，相互排斥的死亡原因上，反映出导致死亡的最初事件。尽管产科患者容易受到下游的致死作用，更直接的死亡致死因素以及非怀孕引起或加重的疾病的影响，但是使用当前报告系统，临床医生和医疗保健决策者都看不到这两种类别以及相关患者属性的负担。因此，在美国，与妊娠相关死亡相关的人群水平的人口统计学，临床特征和资源利用尚未得到充分表征。方法：我们使用德克萨斯州住院患者公共用途数据文件对人群进行了队列研究。该州2001年至2010年间的人口统计学特征，慢性合并症，孕产妇早期死亡的发生，孕产妇死亡的潜在因素以及孕产妇死亡的资源利用。结果：研究期间共有557名孕产妇死亡。慢性合并症的报告率为45.2％。大多数妇女（74.1％）被送入ICU。出血（27.8％），败血症（23.5％）和心血管疾病（22.6％）是最常报告的产妇死亡的潜在病因，其因妊娠相关住院的类别各异。 39％的死者中报告了一种以上的状况。三分之二的妇女在住院的第一天就死亡，在过去的十年中没有太大变化。 65名（11.7％）妇女的平均住院天数为7.9天，总住院费用为$ 250,000或更高。结论：慢性病负担高的发现，各种可能导致怀孕的状况的发生方式-相关死亡，以及当代大量以人口为基础的孕产妇死者队列中的资源密集型需求，可能会更好地为病床旁的预防和干预措施提供信息，并将其作为医疗保健政策的重点。住院提示后，孕产妇快速死亡的普遍且未改变的情况支持着重于识别和有效解决可改善孕产妇结局的一线临床和医疗系统相关绩效领域的方法。对一种以上潜在促成病的常见报道强调了确定孕产妇死亡原因的复杂性。 2015; 7（12）：937-946doi：http://dx.doi.org/10.14740/jocmr2338w

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