Dataset Information

Is a Self-Assessed Questionnaire Useful for the Diagnosis of Ectopic Pregnancy in Hospitalized Patients?

ABSTRACT:

Background

Delayed diagnosis of ectopic pregnancy (EP) is responsible for maternal morbidity and mortality. Our objective was to develop and validate decision rules for the diagnosis of EP, in patients in their first trimester of pregnancy with symptoms, based solely on a self-assessment questionnaire.

Methods

From September 2006 to March 2008, 574 patients, who have consulted for acute pelvic pain at the gynecologic emergency department (ED) of five hospitals, completed a Self-Assessment Questionnaire for Gynecological Emergencies (SAQ-GE). We included for our study only women in their first trimester of pregnancy experiencing acute pelvic pain and/or vaginal bleeding who were hospitalized (262 patients). Two-thirds of patients were selected to derive the SAQ-GE EP score which was built on multiple logistic regression. One third of patients were used for internal validation.

Results

Five variables were independently and significantly (p<0.05) associated with EP: no frequent need to change sanitary towels (aDOR = 6.1; 95% CI [2.1-17.8]), duration of bleeding > 24 hours (aDOR = 4,3; 95% CI [1,7-11,0]), pain during coughing (aDOR = 3.1; CI 95% [1,4-6,7]), brown discharge (aDOR = 3.0; 95% CI [1.3-7.1]) and unilateral pelvic pain (aDOR = 2.7; 95% CI [1.3-5.9]). The SAQ-GE ectopic pregnancy score was based on these five criteria with values ranging from 0 to 100. The low-risk group of EP (score<25) had a sensitivity of 95.9% 95% CI [89.8-98,9] and an LR- of 0.2 95% CI [0.1-0.5]. The high-risk group (score>70) had a specificity of 97.4 95% CI [90.9-99.7] and a LR+ of 12.3 95% CI [3.0-49.8]. The percentages of EP observed in the validation sample were: 0% in the low-risk group and 88.9% in the high-risk group.

Discussion

These prediction rules that classify patients in a low-risk or high-risk group may prove useful for triaging pregnant women in their first trimester with symptoms before complementary exams.

SUBMITTER: Mimoun C

PROVIDER: S-EPMC5104447 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Is a Self-Assessed Questionnaire Useful for the Diagnosis of Ectopic Pregnancy in Hospitalized Patients?

Mimoun Camille C Fauconnier Arnaud A Varas Catalina C Huchon Cyrille C

PloS one 20161110 11

<h4>Background</h4>Delayed diagnosis of ectopic pregnancy (EP) is responsible for maternal morbidity and mortality. Our objective was to develop and validate decision rules for the diagnosis of EP, in patients in their first trimester of pregnancy with symptoms, based solely on a self-assessment questionnaire.<h4>Methods</h4>From September 2006 to March 2008, 574 patients, who have consulted for acute pelvic pain at the gynecologic emergency department (ED) of five hospitals, completed a Self-As ...[more]

PMID: 27832075

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Project description:BACKGROUND: Patients with end-stage renal disease (ESRD) have multiple comorbid conditions. Obtaining comorbidity data from medical records is cumbersome. A self-report comorbidity questionnaire is a useful alternative. Our aim in this study was to examine the predictive value of a self-report comorbidity questionnaire in terms of survival in ESRD patients. METHODS: We studied a prospective cross-sectional cohort of 282 haemodialysis (HD) patients in a single centre. Participants were administered the self-report questionnaire during an HD session. Information on their comorbidities was subsequently obtained from an examination of the patient's medical records. Levels of agreement between parameters derived from the questionnaire, and from the medical records, were examined. Participants were followed-up for 18 months to collect survival data. The influence on survival of comorbidity scores derived from the self-report data (the Composite Self-report Comorbidity Score [CSCS]) and from medical records data--the Charlson Comorbidity Index [CCI] were compared. RESULTS: The level of agreement between the self-report items and those obtained from medical records was almost perfect with respect the presence of diabetes (Kappa score ? 0.97), substantial for heart disease and cancer (? 0.62 and ? 0.72 respectively), moderate for liver disease (? 0.51), only fair for lung disease, arthritis, cerebrovascular disease, and depression (? 0.34, 0.35, 0.34 and 0.29 respectively). The CSCS was strongly predictive of survival in regression models (Nagelkerke R(2) value 0.202), with a predictive power similar to that of the CCI (Nagelkerke R(2) value 0.211). The influences of these two parameters were additive in the models--suggesting that these parameters make different contributions to the assessment of comorbidity. CONCLUSION: This self-report comorbidity questionnaire is a viable tool to collect comorbidity data and may have a role in the prediction of short-term survival in patients with end-stage renal disease on haemodialysis. Further work is required in this setting to refine the tool and define its role.

Dataset Information

Is a Self-Assessed Questionnaire Useful for the Diagnosis of Ectopic Pregnancy in Hospitalized Patients?

Background

Methods

Results

Discussion

Publications

Is a Self-Assessed Questionnaire Useful for the Diagnosis of Ectopic Pregnancy in Hospitalized Patients?

Similar Datasets

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