(127) Identification and Diagnosis of Obstetric Patients at High Risk of Cardiovascular Disease

This is a retrospective cohort study, wherein a system-wide BPA alert and electronic medical record order set was created to help identify and diagnose pregnant and postpartum patients at high risk for cardiovascular disease. Using the patient’s vital signs, diagnoses, and symptoms, and following guidelines provided by the CMQCC, the algorithm identified patients that were at high-risk for cardiovascular disease, and suggested appropriate evaluation and consultation with experts in maternal cardiovascular health. The maternal fetal medicine (MFM) and/or cardiology referral rate, cardiac workup rate, and cardiovascular diagnosis rate were compared from before and after implementation of the BPA. 

Results:

Following implementation of the BPA, there was a significant increase in the proportion of patients undergoing a cardiovascular evaluation (40% to 73%, p = 0.038) and receiving a new cardiovascular diagnosis (45% to 80%, p = 0.020). The rate of referral to cardiology and/or MFM increased from 13% to 33%, but this was not statistically significant within the current sample (p = 0.118). 

Conclusion:

BPAs are valuable tools to help identify pregnant and postpartum patients at high-risk for cardiovascular disease, providing opportunities for intervention. These results have important implications for the early identification and treatment of cardiovascular diseases that contribute to maternal mortality.