Intensive care utilization during hospital admission for delivery: Prevalence, risk factors, and outcomes in a statewide population

Sumedha Panchal, Amelia M. Arria, Andrew Harris

Research output: Contribution to journalArticle

Abstract

Background: During childbirth, the maternal need for intensive care unit (ICU) services is not well-defined. This information could influence the decision whether to incorporate ICU services into the labor and delivery suite. Methods: This study reports (1) ICU use and mortality rates in a statewide population of obstetric patients during their hospital admission for childbirth, and (2) the risk factors associated with ICU admission and mortality. A case-control design using patient records from a state- maintained anonymous database for the years 1984-1997 was used. Outcome variables included ICU use and mortality rates. Results: Of the 822,591 hospital admissions for delivery of neonates during the study period, there were 1,023 ICU admissions (0.12%) and 34 ICU deaths (3.3%). Age, race, hospital type, volume of deliveries, and source of admission independently and in combination were associated with ICU admission (P <0.05). The most common risk factors associated with ICU admission included cesarean section, preeclampsia or eclampsia, and postpartum hemorrhage (P <0.001). Black race, high hospital volume of deliveries, and longer duration of ICU stay were associated with ICU mortality (P <0.05). The most common risk factors associated with ICU mortality included pulmonary complications, shock, cerebrovascular event, and drug dependence (P <0.05). Conclusions: This study shows that ICU use and mortality rate during hospital admission for delivery of a neonate is low. These results may influence the location of perinatal ICU services in the hospital setting.

Original languageEnglish (US)
Pages (from-to)1537-1544
Number of pages8
JournalAnesthesiology
Volume92
Issue number6
StatePublished - Jun 2000
Externally publishedYes

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Critical Care
Intensive Care Units
Population
Mortality
High-Volume Hospitals
Parturition
Newborn Infant
Perinatal Care
Postpartum Hemorrhage
Eclampsia
Pre-Eclampsia
Cesarean Section
Obstetrics
Substance-Related Disorders
Shock

Keywords

  • Critically ill obstetric patient
  • Maternal morbidity
  • Maternal mortality

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Intensive care utilization during hospital admission for delivery : Prevalence, risk factors, and outcomes in a statewide population. / Panchal, Sumedha; Arria, Amelia M.; Harris, Andrew.

In: Anesthesiology, Vol. 92, No. 6, 06.2000, p. 1537-1544.

Research output: Contribution to journalArticle

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