The Effect of Clinical Pathway for Patient with Postpartum Hemorrhage in the Emergency Department
Journal of the Korean Society of Emergency Medicine
; : 585-590, 2015.
Article
in Korean
| WPRIM (Western Pacific)
| ID: wpr-217708
Responsible library:
WPRO
ABSTRACT
PURPOSE:
Postpartum hemorrhage (PPH) is a major cause of maternal death. The aim of this study is to analyze the effect of clinical pathway (CP) and off-hours effects in PPH patients who visit the emergency department.METHODS:
A retrospective study of PPH patients who visited the emergency department between December 1, 2005 and February 28, 2014 was conducted. A multidisciplinary team was designed for PPH in August 1, 2009. We compared time to intervention, volume of transfusion, length of stay (LOS), and uterus preservation rate between the before CP group and after CP group.RESULTS:
A total of 143 post CP groups were compared with 101 before CP visits. Time to operation was less compared with the pre CP group (77 min (22-140) vs 47.5 min (13-114) p=0.011). Volume of transfusion and admission to intensive care units (ICU) were increased in the post CP group. (2 (0-16) vs 2 (0-25) p=0.045, 20 (19.8%) vs 54 (37.8%) p=0.003) LOS of ICU was lower than in the pre CP group and uterus preservation was higher than in the pre CP group. (0 day (0-43) vs 0 day (0-6) p=0.015, 82 (81.2%) vs 129 (90.2%) p=0.042) Time to angiographic embolization was less in the post-CP group with on-duty visits than in post-CP with off hours visits. (38.50 min (16-112) vs 71.0 min (28-633), p=0.025)CONCLUSION:
A clinical pathway for PPH is associated with improvement of uterine preservation rate and reduced LOS of ICU. However this CP could not eliminate off-hour effects from time to intervention.
Full text:
Available
Health context:
SDG3 - Target 3.8 Achieve universal access to health
/
SDG3 - Health and Well-Being
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SDG3 - Target 3.1 Reduce Maternal Mortality
Health problem:
Delivery Arrangements
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Target 3.1: Reduce maternal mortality
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Obstetric Labor Complications
/
Postpartum Hemorrhage
/
Violence & Disasters
Database:
WPRIM (Western Pacific)
Main subject:
Uterus
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Retrospective Studies
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Critical Pathways
/
Postpartum Period
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Emergencies
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Emergency Medicine
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Emergency Service, Hospital
/
Maternal Death
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Postpartum Hemorrhage
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Intensive Care Units
Type of study:
Practice guideline
/
Observational study
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Society of Emergency Medicine
Year:
2015
Document type:
Article