von Dadelszen et al reported the fullPIERS (Preelcampsia Integrated Estimate of Risk) model for evaluating a woman with preeclampsia. The authors are from multiple institutions in Canada, New Zealand, Australia, England and Switzerland.
Website: pre-empt.obgyn.ubc.ca
Patient selection: woman with preeclampsia
Adverse maternal outcomes: maternal mortality; serious morbidity (CNS, hepatic, renal, cardiorespiratory, hematologic)
Parameters:
(1) gestational age at eligibility in weeks
(2) chest pain or dyspnea
(3) serum creatinine in µmol/L
(4) platelet count in 10^9/L
(5) serum AST in U/L
(6) oxygen saturation by pulse oximetry in percent
|
Parameter
|
Finding
|
Points
|
|
gestational age
|
|
-0.0541 * (weeks)
|
|
chest pain or dyspnea
|
no
|
0
|
|
|
yes
|
1.23
|
|
serum creatinine
|
|
-0.0271 * (creatinine)
|
|
platelet count
|
|
(0.207 * (platelet)) + (0.00004 * ((platelet)^2))
|
|
AST
|
|
(0.0101 * (AST)) - (0.00000305 * ((AST)^2))
|
|
Combination
|
Points
|
|
creatinine and platelets
|
0.000250 * (creatinine) * (platelet)
|
|
platelets and AST
|
-0.0000699 * (platelet) * (AST)
|
|
platelets and SpO2
|
-0.00256 * (platelet) * (SpO2)
|
value of X =
= SUM(points for all of the parameters and combinations) + 2.68
probability of adverse maternal outcome =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.88.
