Pyelonephritis in Pregnancy

Prediction of Prolonged Hospitalization and Maternal Morbidity using Prognostic Scoring Systems

Amy M. Valent, Katie Peticca, Alexandra Dimatteo, Shimeka Banks, Ronak Shah, Lindsey Chernicky, Beth Weitz, Casey Armistead, James Hill, Craig Towers, David Lewis, Everett F. Magann, Suneet P. Chauhan, James W.Van Hook

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective This study aims to evaluate the usefulness of prognostic scoring systems to differentiate women admitted for pyelonephritis who develop maternal morbidity and require prolonged hospitalization. Study Design Multicenter retrospective cohort study to compare the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Modified Obstetric Early Warning System (MOEWS) to predict prolonged hospitalization (> 4 days) and composite maternal morbidity for all pregnant women admitted with pyelonephritis between 2012 to 2013. One-way analysis of variance for continuous variables, Fisher's exact test for categorical variables, and receiver operating characteristic curves were used. Results Among 123 pyelonephritis cases analyzed, 25 (20%) required prolonged hospitalization. Women with prolonged hospitalization had higher rates of composite maternal morbidity, required diagnostic imaging, and had delayed administration of intravenous antibiotics (292 ± 381 vs. 218 ± 233 min, p = 0.002). APACHE II and MOEWS scores calculated from data collected within the first 24 hours of admission had a modest ability to discriminate maternal morbidity (APACHE II: area under the curve [AUC], 0.72; 95% confidence interval [CI], 0.58-0.86 and MOEWS: AUC, 0.71; 95% CI, 0.56-0.85). Conclusion We observed that one in five pregnancies admitted for treatment of pyelonephritis requires hospitalization for over 4 days with significant maternal morbidities. Prognostic scoring systems may be useful clinical tools to assess these patients systematically and improve morbidity.

Original languageEnglish (US)
Pages (from-to)1212-1218
Number of pages7
JournalAmerican Journal of Perinatology
Volume34
Issue number12
DOIs
StatePublished - Oct 1 2017

Fingerprint

Prolonged Pregnancy
Pyelonephritis
Hospitalization
Mothers
Morbidity
APACHE
Obstetrics
Area Under Curve
Confidence Intervals
Diagnostic Imaging
ROC Curve
Intravenous Administration
Multicenter Studies
Pregnant Women
Analysis of Variance
Cohort Studies
Retrospective Studies
Anti-Bacterial Agents
Pregnancy

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Pyelonephritis in Pregnancy : Prediction of Prolonged Hospitalization and Maternal Morbidity using Prognostic Scoring Systems. / Valent, Amy M.; Peticca, Katie; Dimatteo, Alexandra; Banks, Shimeka; Shah, Ronak; Chernicky, Lindsey; Weitz, Beth; Armistead, Casey; Hill, James; Towers, Craig; Lewis, David; Magann, Everett F.; Chauhan, Suneet P.; Hook, James W.Van.

In: American Journal of Perinatology, Vol. 34, No. 12, 01.10.2017, p. 1212-1218.

Research output: Contribution to journalArticle

Valent, AM, Peticca, K, Dimatteo, A, Banks, S, Shah, R, Chernicky, L, Weitz, B, Armistead, C, Hill, J, Towers, C, Lewis, D, Magann, EF, Chauhan, SP & Hook, JWV 2017, 'Pyelonephritis in Pregnancy: Prediction of Prolonged Hospitalization and Maternal Morbidity using Prognostic Scoring Systems', American Journal of Perinatology, vol. 34, no. 12, pp. 1212-1218. https://doi.org/10.1055/s-0037-1602418
Valent, Amy M. ; Peticca, Katie ; Dimatteo, Alexandra ; Banks, Shimeka ; Shah, Ronak ; Chernicky, Lindsey ; Weitz, Beth ; Armistead, Casey ; Hill, James ; Towers, Craig ; Lewis, David ; Magann, Everett F. ; Chauhan, Suneet P. ; Hook, James W.Van. / Pyelonephritis in Pregnancy : Prediction of Prolonged Hospitalization and Maternal Morbidity using Prognostic Scoring Systems. In: American Journal of Perinatology. 2017 ; Vol. 34, No. 12. pp. 1212-1218.
@article{f2ecea90bc04484b8c0479b733b68994,
title = "Pyelonephritis in Pregnancy: Prediction of Prolonged Hospitalization and Maternal Morbidity using Prognostic Scoring Systems",
abstract = "Objective This study aims to evaluate the usefulness of prognostic scoring systems to differentiate women admitted for pyelonephritis who develop maternal morbidity and require prolonged hospitalization. Study Design Multicenter retrospective cohort study to compare the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Modified Obstetric Early Warning System (MOEWS) to predict prolonged hospitalization (> 4 days) and composite maternal morbidity for all pregnant women admitted with pyelonephritis between 2012 to 2013. One-way analysis of variance for continuous variables, Fisher's exact test for categorical variables, and receiver operating characteristic curves were used. Results Among 123 pyelonephritis cases analyzed, 25 (20{\%}) required prolonged hospitalization. Women with prolonged hospitalization had higher rates of composite maternal morbidity, required diagnostic imaging, and had delayed administration of intravenous antibiotics (292 ± 381 vs. 218 ± 233 min, p = 0.002). APACHE II and MOEWS scores calculated from data collected within the first 24 hours of admission had a modest ability to discriminate maternal morbidity (APACHE II: area under the curve [AUC], 0.72; 95{\%} confidence interval [CI], 0.58-0.86 and MOEWS: AUC, 0.71; 95{\%} CI, 0.56-0.85). Conclusion We observed that one in five pregnancies admitted for treatment of pyelonephritis requires hospitalization for over 4 days with significant maternal morbidities. Prognostic scoring systems may be useful clinical tools to assess these patients systematically and improve morbidity.",
author = "Valent, {Amy M.} and Katie Peticca and Alexandra Dimatteo and Shimeka Banks and Ronak Shah and Lindsey Chernicky and Beth Weitz and Casey Armistead and James Hill and Craig Towers and David Lewis and Magann, {Everett F.} and Chauhan, {Suneet P.} and Hook, {James W.Van}",
year = "2017",
month = "10",
day = "1",
doi = "10.1055/s-0037-1602418",
language = "English (US)",
volume = "34",
pages = "1212--1218",
journal = "American Journal of Perinatology",
issn = "0735-1631",
publisher = "Thieme Medical Publishers",
number = "12",

}

TY - JOUR

T1 - Pyelonephritis in Pregnancy

T2 - Prediction of Prolonged Hospitalization and Maternal Morbidity using Prognostic Scoring Systems

AU - Valent, Amy M.

AU - Peticca, Katie

AU - Dimatteo, Alexandra

AU - Banks, Shimeka

AU - Shah, Ronak

AU - Chernicky, Lindsey

AU - Weitz, Beth

AU - Armistead, Casey

AU - Hill, James

AU - Towers, Craig

AU - Lewis, David

AU - Magann, Everett F.

AU - Chauhan, Suneet P.

AU - Hook, James W.Van

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Objective This study aims to evaluate the usefulness of prognostic scoring systems to differentiate women admitted for pyelonephritis who develop maternal morbidity and require prolonged hospitalization. Study Design Multicenter retrospective cohort study to compare the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Modified Obstetric Early Warning System (MOEWS) to predict prolonged hospitalization (> 4 days) and composite maternal morbidity for all pregnant women admitted with pyelonephritis between 2012 to 2013. One-way analysis of variance for continuous variables, Fisher's exact test for categorical variables, and receiver operating characteristic curves were used. Results Among 123 pyelonephritis cases analyzed, 25 (20%) required prolonged hospitalization. Women with prolonged hospitalization had higher rates of composite maternal morbidity, required diagnostic imaging, and had delayed administration of intravenous antibiotics (292 ± 381 vs. 218 ± 233 min, p = 0.002). APACHE II and MOEWS scores calculated from data collected within the first 24 hours of admission had a modest ability to discriminate maternal morbidity (APACHE II: area under the curve [AUC], 0.72; 95% confidence interval [CI], 0.58-0.86 and MOEWS: AUC, 0.71; 95% CI, 0.56-0.85). Conclusion We observed that one in five pregnancies admitted for treatment of pyelonephritis requires hospitalization for over 4 days with significant maternal morbidities. Prognostic scoring systems may be useful clinical tools to assess these patients systematically and improve morbidity.

AB - Objective This study aims to evaluate the usefulness of prognostic scoring systems to differentiate women admitted for pyelonephritis who develop maternal morbidity and require prolonged hospitalization. Study Design Multicenter retrospective cohort study to compare the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Modified Obstetric Early Warning System (MOEWS) to predict prolonged hospitalization (> 4 days) and composite maternal morbidity for all pregnant women admitted with pyelonephritis between 2012 to 2013. One-way analysis of variance for continuous variables, Fisher's exact test for categorical variables, and receiver operating characteristic curves were used. Results Among 123 pyelonephritis cases analyzed, 25 (20%) required prolonged hospitalization. Women with prolonged hospitalization had higher rates of composite maternal morbidity, required diagnostic imaging, and had delayed administration of intravenous antibiotics (292 ± 381 vs. 218 ± 233 min, p = 0.002). APACHE II and MOEWS scores calculated from data collected within the first 24 hours of admission had a modest ability to discriminate maternal morbidity (APACHE II: area under the curve [AUC], 0.72; 95% confidence interval [CI], 0.58-0.86 and MOEWS: AUC, 0.71; 95% CI, 0.56-0.85). Conclusion We observed that one in five pregnancies admitted for treatment of pyelonephritis requires hospitalization for over 4 days with significant maternal morbidities. Prognostic scoring systems may be useful clinical tools to assess these patients systematically and improve morbidity.

UR - http://www.scopus.com/inward/record.url?scp=85018340955&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018340955&partnerID=8YFLogxK

U2 - 10.1055/s-0037-1602418

DO - 10.1055/s-0037-1602418

M3 - Article

VL - 34

SP - 1212

EP - 1218

JO - American Journal of Perinatology

JF - American Journal of Perinatology

SN - 0735-1631

IS - 12

ER -