(625) Comparison of a New Tool for Obstetric Early Sepsis Versus Systemic Inflammatory Response Syndrome (SIRS)

To compare a new clinical screening tool for obstetric early sepsis (TOES) against established SIRS criteria.

Study Design:

Retrospective case-control study of sixty-five patients diagnosed with sepsis either antepartum or within three days of delivery. Sepsis was diagnosed utilizing the SIRS criteria. Sixty-five random controls with similar demographics without sepsis were used. The TOES tool (Table 1) was developed utilizing pregnancy-specific clinical parameters only excluding laboratory evaluations. The sensitivity, specificity, positive predictive and negative predictive values for TOES were determined.  Group comparisons were performed with the Mann-Whitney Rand Sum test. Significance was set at a P value < 0.05.

Results:

There were no differences in the demographics (age, race, BMI, gravidity, parity, and gestational age) between the two groups. The temperature, respiratory rate, heart rate and TOES score were all higher in the sepsis group (P < 0.001). There was no difference between the systolic, diastolic and the mean arterial pressures (MAP) between the two groups. The sensitivity, specificity, positive predictive and negative predictive values for TOES were 95.4%, 96.9%, 96.9 % and 95.5% respectively.

Conclusion:

TOES performed comparably to SIRS in screening for obstetric sepsis. We speculate that TOES, which only requires clinical parameters without laboratory testing may facilitate earlier identification of obstetric sepsis over traditional screening tools. We suggest that TOES may demonstrate improved clinical utility which may decrease adverse outcomes. Further validation of TOES with a prospective cohort is suggested.