Validación del índice de shock como predictor de severidad de la hemorragia postparto en puérperas atendidas en el Hospital Vicente corral Moscoso. Cuenca, 2020

Abstract

Background: postpartum hemorrhage is one of the leading causes of maternal death. Diagnosis is primarily clinical; In recent years, the Shock Index (SI) has been studied as an accurate predictor of hypovolemia, a value greater than or equal to 0.9 is considered a marker of PPH severity. Objective: to evaluate the Shock Index as a predictor of PPH severity in puerperal women treated at the Vicente Corral Moscoso Hospital. Cuenca, 2020. Methodological design: quantitative observational study of diagnostic test validation in which 150 patients with postpartum hemorrhage participated. The dependent variable was the severity of postpartum hemorrhage and the independent variable was the shock index. The analysis was performed with the SPSS v.25 program according to the type of variables, frequency and percentage for qualitative variables, and mean and standard deviation for quantitative variables. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and ROC curve are reported to assess the association between IS and postpartum hemorrhage severity. Results: of the 150 patients diagnosed with postpartum hemorrhage, 40.7% of the patients presented severe bleeding and the most frequent severity criterion was surgical intervention to stop the bleeding. A shock index ≥ 0.9 has a sensitivity of 44.3%, specificity of 51.7%, PPV of 36.8%, and NPV of 57.5% for predicting severe postpartum hemorrhage. Conclusions: an SI ≥ 0.9 has low validity to predict severe postpartum hemorrhage.