Desenlaces clínicos asociados a la activación de código rojo en pacientes con hemorragia postparto en el Hospital Universitario Mayor – Méderi, 2014 a 2017
Thesis
Background: Postpartum hemorrhage is an important determinant of maternal morbidity and mortality worldwide; it is the first cause of obstetric death in the world and the second in Colombia. The “Code Red” represents a rapid response strategy in healthcare institutions. The objective of this study was to establish the association of code red activation with the clinical outcomes of the patients. Materials and Methods: a retrospective cohort analytical study was conducted between 2014 and 2017. 363 patients with postpartum hemorrhage were included, two cohorts were made depending on whether or not a code red was activated. Results: The overall incidence of postpartum hemorrhage was 2.4% on IV level of complexity hospital. The average age was 25.7 ± 6.0 years, the main risk factors were conduction or induction of labor and multiparity. The main diagnosis was uterine atony, followed by retention of placental remains. Significant association was found between code red activation with blood reserve (RR=5.10, 95% CI: 3.60.7.24, p=<0.001), increase in blood transfusion requirement (RR=3.19, 95% CI: 2.09 , 4.85, p=<0.001), more units received from blood products (2.52 ± 1.0 units vs. 2.29 ± 0.62 units, p=<0.001), higher admission to ICU (RR=4.08, 95% CI: 2.57.6.47, p <0.001) and no association was found with mortality (p=0.366). Conclusions: The activation of the “code red” was significantly associated with blood reserve and transfusion, number of transfused units and intensive care unit admission and was not associated with mortality. It is recommended that all health institutions establish the management protocol for postpartum hemorrhage, where the code red is included as a strategy to minimize risks and complications for patients.
