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Povzetek: Severe maternal morbidity is a major global health concern, and early identification of at-risk postpartum women is essential to improving outcomes. We aimed to compare the predictive values of the Modified Early Obstetric Warning System (MEOWS) versus the non-obstetric general Early Warning System (EWS) for predicting severe maternal morbidity in postpartum women. We retrospectively reviewed hospital documentation of 723 postpartum women admitted to the obstetric high dependency unit between October 2020 and March 2021. Severe maternal morbidity was defined using the American College of Obstetricians and Gynecologists' criteria. We assessed the sensitivity, specificity, positive and negative predictive values, as well as positive and negative likelihood ratios, of the MEOWS and the EWS for predicting severe postpartum maternal morbidity. Twenty-four (3.3%) women included in the study met the criteria for severe maternal morbidity. Hypertensive complications and obstetric haemorrhage were the most prevalent causes of maternal morbidity. The sensitivity of the MEOWS was 92%, specificity 62%, positive predictive value 8%, and negative predictive value 100%. The positive likelihood ratio was 2.4, while the negative likelihood ratio was 0.1. In comparison, the EWS had a sensitivity of 63%, specificity of 66%, positive predictive value of 6%, and negative predictive value of 98%. The positive likelihood ratio for the EWS was 1.8, and the negative likelihood ratio was 0.6. The obstetric-specific early warning system proved to be superior for the early prediction of severe postpartum maternal morbidity compared to the general non-obstetric warning system.
Ključne besede: severe maternal morbidity, postpartum period, modified early obstetric warning system, MEOWS
Objavljeno v DiRROS: 09.04.2026; Ogledov: 161; Prenosov: 114
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Povzetek: Background: Data on multinational 90-day mortality and morbidity rates after surgery for gastric cancer is limited in the literature. This study aimed to understand the 90-day mortality and morbidity outcomes among patients undergoing elective gastric cancer surgery, as in the GASTRODATA Registry, and to identify associated risk factors. Methods: We conducted an international prospective study on patients aged ≥ 18 years undergoing elective surgery for gastric cancer with curative intent from January 4 to September 30, 2022. Known metastatic disease, concurrent secondary cancers, gastrointestinal stromal tumour (GIST) and Siewert type I/II oesophagogastric junction malignancies were excluded. Univariate and multivariate logistic regression were used to identify variables associated with the 90-day outcome. Results: 380 collaborators from 47 countries submitted data on 1538 patients. Median age was 65 years (IQR: 19–94), and 58.5% were males. 90-day morbidity and mortality rates were 38.2% (n = 587) and 2.9% (n = 45), respectively. Pre-operative higher Charlson Comorbidity Index, higher ASA score, pre-operative weight loss > 10%, positive specimen margin, and post-operative pathological IV staging (p value < 0.05) were significantly associated with clinically relevant complications and mortality. Conclusion: Elective gastric cancer surgery has a 90-day morbidity of 38.2% and a 90-day mortality of 2.9% globally. This study provided the most comprehensive international 90-day prospective data to date regarding gastric cancer surgery. Several factors associated with higher morbidity were identified, highlighting the importance of a unified language on surgical morbidity, prehabilitation, and ongoing audits to enhance patient outcomes.
Ključne besede: gastric cancer, elective surgery, morbidity, mortality, 90-day postoperative outcomes, multinational audit, surgical complications, anastomotic leaks, patient safety
Objavljeno v DiRROS: 16.12.2025; Ogledov: 1730; Prenosov: 210
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