J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 7, Number 12, December 2015, pages 937-946

Patterns of the Demographics, Clinical Characteristics, and Resource Utilization Among Maternal Decedents in Texas, 2001 - 2010: A Population-Based Cohort Study

**Table 1.** The Demographic Characteristics, Health Insurance and Categories of Pregnancy-Associated Hospitalizations Among Maternal Decedents
Group	Maternal decedents (n = 557)
Age (years), n (%)
< 18	22 (3.9)
18 - 34	411 (73.8)
≥ 35	124 (22.3)
Race/ethnicity, n (%)
Hispanic	227 (40.8)
Black	127 (22.8)
White	156 (28)
Other	47 (8.4)
Health insurance, n (%)
Private	169 (30.3)
Medicaid	268 (48.1)
Medicare	16 (2.9)
Uninsured	88 (15.8)
Other	16 (2.9)
Category of hospitalization, n (%)
Miscarriage/abortion	61 (11)
Delivery	321 (57.6)
Postpartum	100 (18)
Antepartum	75 (13.4)

Table 1. The Demographic Characteristics, Health Insurance and Categories of Pregnancy-Associated Hospitalizations Among Maternal Decedents

Group

Maternal decedents (n = 557)

Age (years), n (%)

< 18

22 (3.9)

18 - 34

411 (73.8)

≥ 35

124 (22.3)

Race/ethnicity, n (%)

Hispanic

227 (40.8)

Black

127 (22.8)

White

156 (28)

Other

47 (8.4)

Health insurance, n (%)

Private

169 (30.3)

Medicaid

268 (48.1)

Medicare

16 (2.9)

Uninsured

88 (15.8)

Other

16 (2.9)

Category of hospitalization, n (%)

Miscarriage/abortion

61 (11)

Delivery

321 (57.6)

Postpartum

100 (18)

Antepartum

75 (13.4)

**Table 2.** Chronic Comorbidities Among Maternal Decedents
Group	Maternal decedents (n = 557)
¹Based on conditions included in the Deyo-Charlson comorbidity index. IQR: interquartile range; SD: standard deviation.
Any chronic comorbidity, n (%)¹	252 (45.2)
Deyo-Charlson score
Median (IQR)	0 (0 - 1)
Mean (SD)	0.9 (1.5)
Myocardial infarction	19 (3.4)
Congestive heart failure	53 (9.5)
Peripheral vascular disease	26 (4.7)
Cerebrovascular disease	77 (13.8)
Chronic lung disease	24 (4.3)
Connective tissue disease	16 (2.9)
Diabetes mellitus	27 (4.8)
Chronic kidney disease	15 (2.7)
Malignancy	17 (3.1)
Chronic liver disease	63 (11.3)
Human immunodeficiency virus infection	9 (1.6)
Obesity	24 (4.3)
Alcohol abuse	1 (0.2)
Drug abuse	32 (5.7)
Smoking	7 (1.3)

Table 2. Chronic Comorbidities Among Maternal Decedents

Group

Maternal decedents (n = 557)

¹Based on conditions included in the Deyo-Charlson comorbidity index. IQR: interquartile range; SD: standard deviation.

Any chronic comorbidity, n (%)¹

252 (45.2)

Deyo-Charlson score

Median (IQR)

0 (0 - 1)

Mean (SD)

0.9 (1.5)

Myocardial infarction

19 (3.4)

Congestive heart failure

53 (9.5)

Peripheral vascular disease

26 (4.7)

Cerebrovascular disease

77 (13.8)

Chronic lung disease

24 (4.3)

Connective tissue disease

16 (2.9)

Diabetes mellitus

27 (4.8)

Chronic kidney disease

15 (2.7)

Malignancy

17 (3.1)

Chronic liver disease

63 (11.3)

Human immunodeficiency virus infection

9 (1.6)

Obesity

24 (4.3)

Alcohol abuse

1 (0.2)

Drug abuse

32 (5.7)

Smoking

7 (1.3)

**Table 3.** Potential Contributing Conditions Among Maternal Decedents
Group	Maternal decedents (n = 557)
Hemorrhage, n (%)	155 (27.8)
Embolism, n (%)	62 (11.1)
Preeclampsia/eclampsia, n (%)	111 (19.9)
Sepsis, n (%)	131 (23.5)
Anesthesia complications, n (%)	4 (0.7)
Cardiomyopathy, n (%)	71 (12.7)
Cerebrovascular accident, n (%)	91 (16.3)
Cardiovascular conditions, n (%)	126 (22.6)

Table 3. Potential Contributing Conditions Among Maternal Decedents

Group

Maternal decedents (n = 557)

Hemorrhage, n (%)

155 (27.8)

Embolism, n (%)

62 (11.1)

Preeclampsia/eclampsia, n (%)

111 (19.9)

Sepsis, n (%)

131 (23.5)

Anesthesia complications, n (%)

4 (0.7)

Cardiomyopathy, n (%)

71 (12.7)

Cerebrovascular accident, n (%)

91 (16.3)

Cardiovascular conditions, n (%)

126 (22.6)

**Table 4.** Potential Contributing Conditions Among Maternal Decedents, Across Categories of Pregnancy-Associated Hospitalizations
Group	Category of pregnancy-associated hospitalization
¹Percentage figures refer to the frequency of reporting of the examined potential contributing condition among maternal decedents during a specific category of pregnancy-associated hospitalization.
Hemorrhage, n (%)¹	19 (31.1)	124 (38.6)	3 (3)	9 (12)
Embolism, n (%)	5 (8.2)	40 (12.5)	13 (13)	4 (5.3)
Preeclampsia/eclampsia, n (%)	2 (3.3)	94 (29.3)	12 (12)	3 (4)
Sepsis, n (%)	24 (39.3)	61 (19)	29 (29)	17 (22.7)
Cardiomyopathy, n (%)	4 (6.6)	27 (8.4)	35 (35)	5 (6.7)
Cerebrovascular accident, n (%)	3 (4.9)	40 (12.5)	44 (44)	4 (5.3)
Cardiovascular conditions, n (%)	15 (24.6)	52 (16.2)	46 (46)	13 (17.3)

Table 4. Potential Contributing Conditions Among Maternal Decedents, Across Categories of Pregnancy-Associated Hospitalizations

Group

Category of pregnancy-associated hospitalization

Miscarriage/abortion (n = 61)

Delivery (n = 321)

Postpartum (n = 100)

Antepartum (n = 75)

¹Percentage figures refer to the frequency of reporting of the examined potential contributing condition among maternal decedents during a specific category of pregnancy-associated hospitalization.

Hemorrhage, n (%)¹

19 (31.1)

124 (38.6)

3 (3)

9 (12)

Embolism, n (%)

5 (8.2)

40 (12.5)

13 (13)

4 (5.3)

Preeclampsia/eclampsia, n (%)

2 (3.3)

94 (29.3)

12 (12)

3 (4)

Sepsis, n (%)

24 (39.3)

61 (19)

29 (29)

17 (22.7)

Cardiomyopathy, n (%)

4 (6.6)

27 (8.4)

35 (35)

5 (6.7)

Cerebrovascular accident, n (%)

3 (4.9)

40 (12.5)

44 (44)

4 (5.3)

Cardiovascular conditions, n (%)

15 (24.6)

52 (16.2)

46 (46)

13 (17.3)

**Table 5.** The Demographic Characteristics and Health Insurance Among the Women Who Died During Their First Day of Hospitalizations and the Share of the Examined Characteristics out of the Whole Cohort of Maternal Decedents
Group	Deaths on hospital day 1 (n = 192)	All maternal decedents (n = 557)
¹Percentages represent occurrence of examined attributes among the women who died during their first day of hospitalization. ²Percentages represent occurrence of the examined attributes among women who died during their first day of hospitalization out of all maternal decedents with the same attribute.
Age (years), n (%)
< 18	7 (3.6)¹	7/22 (31.8)²
18 - 34	138 (78.9)	138/411 (33.6)
≥ 35	47 (24.5)	47/124 (37.9)
Race/ethnicity, n (%)
Hispanic	60 (31.3)	60/227 (26.4)
Black	42 (21.9)	42/127 (33)
White	68 (35.4)	68/156 (43.6)
Other	22 (11.5)	22/47 (46.8)
Health insurance, n (%)
Private	71 (37)	71/169 (42)
Medicaid	79 (41.1)	79/268 (29.5)
Medicare	2 (1)	2/16 (12.5)
Uninsured	39 (20.3)	39/88 (44.3)
Other	1 (0.5)	1/16 (6.3)

Table 5. The Demographic Characteristics and Health Insurance Among the Women Who Died During Their First Day of Hospitalizations and the Share of the Examined Characteristics out of the Whole Cohort of Maternal Decedents

Group

Deaths on hospital day 1 (n = 192)

All maternal decedents (n = 557)

¹Percentages represent occurrence of examined attributes among the women who died during their first day of hospitalization. ²Percentages represent occurrence of the examined attributes among women who died during their first day of hospitalization out of all maternal decedents with the same attribute.

Age (years), n (%)

< 18

7 (3.6)¹

7/22 (31.8)²

18 - 34

138 (78.9)

138/411 (33.6)

≥ 35

47 (24.5)

47/124 (37.9)

Race/ethnicity, n (%)

Hispanic

60 (31.3)

60/227 (26.4)

Black

42 (21.9)

42/127 (33)

White

68 (35.4)

68/156 (43.6)

Other

22 (11.5)

22/47 (46.8)

Health insurance, n (%)

Private

71 (37)

71/169 (42)

Medicaid

79 (41.1)

79/268 (29.5)

Medicare

2 (1)

2/16 (12.5)

Uninsured

39 (20.3)

39/88 (44.3)

Other

1 (0.5)

1/16 (6.3)

**Table 6.** The Categories of Pregnancy-Associated Hospitalizations and Potential Contributing Conditions Among the Women Who Died During Their First Day of Hospitalizations and the Share of the Examined Characteristics out of the Whole Cohort of Maternal Decedents
Group	Deaths on hospital day 1 (n = 192)	All maternal decedents (n = 557)
¹Percentages represent occurrence of examined attributes among the women who died during their first day of hospitalization. ²Percentages represent occurrence of the examined attributes among women who died during their first day of hospitalization out of all maternal decedents with the same attribute.
Category of hospitalization, n (%)
Miscarriage/abortion	23 (12)¹	23/61 (37.7)²
Delivery	114 (59.4)	114/321 (35.5)
Postpartum	23 (12)	23/100 (23)
Antepartum	32 (16.7)	32/75 (42.7)
Potential contributing conditions
Hemorrhage, n (%)	65 (33.9)	65/153 (39.9)
Embolism, n (%)	31 (16.1)	31/62 (50)
Preeclampsia/eclampsia, n (%)	29 (15.1)	29/111 (26.1)
Sepsis, n (%)	23 (12)	23/131 (17.6)
Cardiomyopathy, n (%)	6 (3.1)	6/43 (14)
Cerebrovascular accident, n (%)	15 (7.8)	15/77 (19.5)
Cardiovascular conditions, n (%)	22 (11.5)	22/93 (23.7)

Table 6. The Categories of Pregnancy-Associated Hospitalizations and Potential Contributing Conditions Among the Women Who Died During Their First Day of Hospitalizations and the Share of the Examined Characteristics out of the Whole Cohort of Maternal Decedents

Group

Deaths on hospital day 1 (n = 192)

All maternal decedents (n = 557)

Category of hospitalization, n (%)

Miscarriage/abortion

23 (12)¹

23/61 (37.7)²

Delivery

114 (59.4)

114/321 (35.5)

Postpartum

23 (12)

23/100 (23)

Antepartum

32 (16.7)

32/75 (42.7)

Potential contributing conditions

Hemorrhage, n (%)

65 (33.9)

65/153 (39.9)

Embolism, n (%)

31 (16.1)

31/62 (50)

Preeclampsia/eclampsia, n (%)

29 (15.1)

29/111 (26.1)

Sepsis, n (%)

23 (12)

23/131 (17.6)

Cardiomyopathy, n (%)

6 (3.1)

6/43 (14)

Cerebrovascular accident, n (%)

15 (7.8)

15/77 (19.5)

Cardiovascular conditions, n (%)

22 (11.5)

22/93 (23.7)

**Table 7.** Resource Utilization Among Maternal Decedents
Group	Maternal decedents (n = 557)
¹Adjusted for inflation to 2010 dollars.
Admission to ICU, n (%)	413 (74.1)
Total hospital charges (dollars)¹
Median (IQR)	57,709 (24,132 - 119,273)
Mean (SD)	139,029 (340,739)
Hospital length of stay (days)
Median (IQR)	3 (1 - 8)
Mean (SD)	7.9 (17)

Table 7. Resource Utilization Among Maternal Decedents

Group

Maternal decedents (n = 557)

¹Adjusted for inflation to 2010 dollars.

Admission to ICU, n (%)

413 (74.1)

Total hospital charges (dollars)¹

Median (IQR)

57,709 (24,132 - 119,273)

Mean (SD)

139,029 (340,739)

Hospital length of stay (days)

Median (IQR)

3 (1 - 8)

Mean (SD)

7.9 (17)