干旱区生态环境知识资源中心(Arid): Risk of obstetric anal sphincter injuries at the time of admission for delivery: A clinical prediction model

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DOI	10.1111/1471-0528.17239
	Risk of obstetric anal sphincter injuries at the time of admission for delivery: A clinical prediction model
	Luchristt, Douglas; Meekins, Ana Rebecca; Zhao, Congwen; Grotegut, Chad; Siddiqui, Nazema Y.; Alhanti, Brooke; Jelovsek, John Eric
通讯作者	Luchristt, D
来源期刊	BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
ISSN	1470-0328
EISSN	1471-0528
出版年	2022
卷号	129 期号:12 页码:2062-2069
英文摘要	Objective To develop and validate a model to predict obstetric anal sphincter injuries (OASIS) using only information available at the time of admission for labour. Design A clinical predictive model using a retrospective cohort. Setting A US health system containing one community and one tertiary hospital. Sample A total of 22 873 pregnancy episodes with in-hospital delivery at or beyond 21 weeks of gestation. Methods Thirty antepartum risk factors were identified as candidate variables, and a prediction model was built using logistic regression predicting OASIS versus no OASIS. Models were fit using the overall study population and separately using hospital-specific cohorts. Bootstrapping was used for internal validation and external cross-validation was performed between the two hospital cohorts. Main outcome measures Model performance was estimated using the bias-corrected concordance index (c-index), calibration plots and decision curves. Results Fifteen risk factors were retained in the final model. Decreasing parity, previous caesarean birth and cardiovascular disease increased risk of OASIS, whereas tobacco use and black race decreased risk. The final model from the total study population had good discrimination (c-index 0.77, 95% confidence interval [CI] 0.75-0.78) and was able to accurately predict risks between 0 and 35%, where average risk for OASIS was 3%. The site-specific model fit using patients only from the tertiary hospital had c-stat 0.74 (95% CI 0.72-0.77) on community hospital patients, and the community hospital model was 0.77 (95%CI 0.76-0.80) on the tertiary hospital patients. Conclusions OASIS can be accurately predicted based on variables known at the time of admission for labour. These predictions could be useful for selectively implementing OASIS prevention strategies.
英文关键词	clinical prediction tools obstetric anal sphincter injury severe perineal laceration
类型	Article
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000807231000001
WOS关键词	QUALITY-OF-LIFE ; INCONTINENCE ; NEED
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/391996
推荐引用方式 GB/T 7714	Luchristt, Douglas,Meekins, Ana Rebecca,Zhao, Congwen,et al. Risk of obstetric anal sphincter injuries at the time of admission for delivery: A clinical prediction model[J],2022,129(12):2062-2069.
APA	Luchristt, Douglas.,Meekins, Ana Rebecca.,Zhao, Congwen.,Grotegut, Chad.,Siddiqui, Nazema Y..,...&Jelovsek, John Eric.(2022).Risk of obstetric anal sphincter injuries at the time of admission for delivery: A clinical prediction model.BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY,129(12),2062-2069.
MLA	Luchristt, Douglas,et al."Risk of obstetric anal sphincter injuries at the time of admission for delivery: A clinical prediction model".BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY 129.12(2022):2062-2069.