Evaluation of different blood pressure assessment strategies and cutoff values to predict postpartum hypertension-related readmissions: a retrospective cohort study

BackgroundThe American College of Obstetricians and Gynecologists suggests the initiation postpartum antihypertensive treatment for women with hypertension in period, a systolic blood pressure ≥150 mm Hg or diastolic ≥100 on 2 occasions at least 4 to 6 hours apart; however, utility validity this strategy preventing hypertension-related readmission remain unknown.ObjectiveThe primary objective was evaluate accuracy different assessment strategies predicting readmissions. The secondary consider impact using thresholds initiating vs current threshold recommended by Gynecologists.Study DesignA retrospective cohort study 24,917 who delivered single midwestern academic hospital between January 1, 2009, June 30, 2015. Of those women, 3830 were identified as hypertensive, 112 (2.92%) readmitted management. Blood pressures measured delivery 72 after used 3 strategies: average exceeding predetermined (strategy 1), maximum 1 occasion 2), apart 3). Analyzed included all integer values 100/50 160/110 120/70 190/140 3. outcome readmission. Receiver operating characteristic curves area under curve measure predictive value these strategies.ResultsThe Gynecologists’ recommendation ≥150/100 had sensitivity 38% specificity 95%, whereas following reducing 140/90 demonstrated 71% 84%. follows: (area curve, 0.81; 95% confidence interval, 76.95–85.08), 0.79; 74.70–82.81), 0.83; 79.83–87.24). difference areas statistically significant (P<.0001).ConclusionThe lower can predict readmissions higher specificity. Compared Hg, if lowered ≥140/90 it would significantly reduce unknown. Gynecologists. A strategies. (P<.0001).