Diagnostic validation of the fullpiers scale for severe preeclampsia in a highaltitude hospital in peru

Gallegos-Diaz C.A.; Moquillaza-Alcantara V.H. · Revista del Cuerpo Medico Hospital Nacional Almanzor Aguinaga Asenjo (2025) · DOI: 10.35434/rcmhnaaa.2025.183.2734

Resumen

Introduction: High-altitude environments predispose individuals to hypertensive disorders during pregnancy; however, the lack of laboratory facilities often limits accurate diagnosis. Objective: To determine the validity of the FullPIERS scale as a prognostic tool for severe preeclampsia in populations living at high altitudes. Materials and Methods: A cross-sectional diagnostic validation study was conducted. Medical records from 284 pregnant women with preeclampsia treated at a high-altitude hospital were reviewed. The gold standard was a verified clinical diagnosis, and the FullPIERS scale aimed to estimate severity based on gestational age, chest pain, platelet count, creatinine levels, aspartate aminotransferase concentrations, and oxygen saturation, using a 30% risk threshold from the FullPIERS calculator. Results: In the high-altitude hospital, 60% of pregnant women with preeclampsia developed severe disease. At a 30% threshold, the FullPIERS scale demonstrated a sensitivity of 29.21% (95%CI:23.03-36.28%), specificity of 86.79% (95%CI:79.04-91.97%), positive predictive value of 78.79% (95%CI:67.49-86.92%), negative predictive value of 42.20% (95%CI:35.84-48.84%), and accuracy of 50.70% (95%CI:44.92-56.47%). The area under the curve was 58% (95%CI:51.25-64.75%). Conclusion: Using a 30% threshold, the FullPIERS scale presents an AUC of 58% for estimating the severity of preeclampsia in a high-altitude hospital setting.

Instituciones: Universidad César Vallejo