Evaluation of the Obstetric Quality-of-Recovery score (ObsQoR-11) following non-elective caesarean delivery

Ciechanowicz, S.; Howle, Ryan; Heppolette, C.; Nakhjavani, B.; Carvalho, Brendan; Sultan, Pervez

doi:10.1016/j.ijoa.2019.01.010

Cited by 43 publications

(42 citation statements)

References 26 publications

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“…were standardized PROMs: Inventory of Functional Status After Childbirth, 23 Barkin Index of Maternal Functioning, 24 Maternal Concerns Questionnaire, 25 33 This PROM has been used in 1 further published study 34 included in the literature search.…”

Section: Global Recovery Promsmentioning

confidence: 99%

Evaluation of Domains of Patient-Reported Outcome Measures for Recovery After Childbirth

et al. 2020

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IMPORTANCE Despite the global delivery rate being approximately 259 deliveries per minute in 2018, postpartum recovery remains poorly defined. OBJECTIVES To identify validated patient-reported outcome measures (PROMs) used to assess outpatient and inpatient postpartum recovery, evaluate frequency of PROM use, report the proportion of identified PROMs used within each recovery domain, report the number of published studies within each recovery domain, summarize descriptive data (country of origin, year of study, and journal specialty) for published studies using PROMs to evaluate postpartum recovery, and report PROMs used to evaluate global postpartum recovery. EVIDENCE REVIEW This study followed PRISMA-ScR guidelines. A literature search of 4 databases (MEDLINE through PubMed, Embase, Web of Science, and CINAHL) was performed on July 1, 2019, to identify PROMs used to evaluate 12 author-defined domains of postpartum recovery. All psychometrically evaluated PROMs used to evaluate inpatient or outpatient postpartum recovery after all delivery modes were included. FINDINGS From 8008 screened titles and abstracts, 573 studies (515 outpatient and 58 inpatient) were identified in this review. A total of 201 PROMs were used to assess recovery for outpatient studies and 73 PROMs were used to assess recovery for inpatient studies. The top 5 domains (with highest to lowest numbers of PROMs) used to assess outpatient recovery were psychosocial distress (77 PROMs), surgical complications (26 PROMs), psychosocial support (27 PROMs), motherhood experience (16 PROMs), and sexual function (13 PROMs). Among inpatient studies, the top 5 domains were psychosocial distress (32 PROMs), motherhood experience (7 PROMs), psychosocial support (5 PROMs), fatigue (5 PROMs), and cognition (3 PROMs). The 3 most frequently used PROMs were the Edinburgh Postnatal Depression Scale (267 studies), Short-Form 36 Health Questionnaire (global recovery assessment; 40 studies), and Female Sexual Function Index (35 studies). A total of 24 global recovery PROMs were identified among all included studies. Most studies were undertaken in the United States within the last decade and were published in psychiatry and obstetrics and gynecology journals. CONCLUSIONS AND RELEVANCE Most PROMs identified in this review evaluated a single domain of recovery. Future research should focus on determining the psychometric properties of individual and global recovery PROMs identified in this review to provide recommendations regarding optimum measures of postpartum recovery.

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Section: Global Recovery Promsmentioning

confidence: 99%

Evaluation of Domains of Patient-Reported Outcome Measures for Recovery After Childbirth

et al. 2020

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“…We attribute this to the level of supervision provided to women during patient-reported outcome measure completion. In previous studies, researchers were physically present during questionnaire completion, 7,8 whereas women in this study were not directly supervised. An advantage of utilizing EQ-5D-3L was that it allowed the identification of inconsistent reporting among patients.…”

Section: Original Researchmentioning

confidence: 99%

Evaluation of inpatient postpartum recovery using the Obstetric Quality of Recovery-10 patient-reported outcome measure: a single-center observational study

Sultan

Kamath

Carvalho

et al. 2020

American Journal of Obstetrics & Gynecology MFM

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BACKGROUND: Few adequately validated patient-reported outcome measures are available, which can assess recovery profiles following childbirth. OBJECTIVE: We aimed to determine whether quantitative recovery (using the Obstetric Quality of Recovery-10 patient-reported outcome measure) was superior following vaginal delivery compared with cesarean delivery and evaluate validity, reliability, and responsiveness of this patientreported outcome measure in the obstetrical setting in the United States. STUDY DESIGN: Women recruited into this single-center observational cohort study completed the Obstetric Quality of Recovery-10 and EuroQol 5-dimension 3L patient-reported outcome measures within 72 hours of childbirth. We assessed the validity with hypothesis testing and structural validity. In hypothesis testing, the primary outcome was Obstetric Quality of Recovery-10 scores after vaginal vs cesarean delivery. Secondary outcomes were differences in Obstetric Quality of Recovery-10 scores for vaginal delivery following induction of labor vs spontaneous labor and scheduled vs unplanned cesarean delivery, correlation with clinical parameters (American Society of Anesthesiologists classification grade, body mass index, length of hospital stay, estimated blood loss, transfusion requirement, antiemetic use, and neonatal intensive care unit admission), and qualitative ranking of Obstetric Quality of Recovery-10 items for each delivery mode. Structural validity was assessed by determining the correlation of the Obstetric Quality of Recovery-10 scores with the EuroQol 5-dimension 3L and global health visual analog scale scores. Reliability was assessed using Cronbach alpha and inter-item correlation of Obstetric Quality of Recovery-10 items. Responsiveness was assessed by evaluating the change in Obstetric Quality of Recovery-10 scores over the 72-hour postpartum period. RESULTS: Data from 215 women were analyzed. In hypothesis testing, the median (interquartile range) Obstetric Quality of Recovery-10 scores were higher following vaginal delivery than cesarean delivery (86 [77e94] vs 77 [64e86], respectively; P<.001). Multivariate model demonstrated that Obstetric Quality of Recovery-10 scores were significantly lower after cesarean delivery when adjusting for American Society of Anesthesiologists classification grade, age, body mass index, and ethnicity (R¼À8.97; P<.001). Obstetric Quality of Recovery-10 scores were similar between induction of labor and spontaneous labor, and scheduled cesarean delivery and unplanned cesarean delivery. Obstetric Quality of Recovery-10 was correlated with length of hospital stay (R¼À0.248; P<.001), estimated blood loss (R¼À0.3429; P<.001), transfusion requirement (R¼À0.140; P¼.041), and antiemetic use (R¼À0.280; P<.001). The highest ranked Obstetric Quality of Recovery-10 items were ability to hold baby, feeling in control, and ability to look after personal hygiene. The lowest ranked items were pain and shivering. In structural validity, correlation of Obstetric Quality of Recovery-10 score wa...

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“…proposed by Ciechanowicz S. proved to be reliable, clinically acceptable, and feasible, is effective in patients undergoing elective and emergency cesarean section [15,25] . In this study, all questionnaire feedback had been received and the results showed that scores in group DB was higher than in both group FB and group B (P < 0.017), suggesting that parturients in combination with 5 ug of DEX have a better recovery quality.…”

Section: Discussionmentioning

confidence: 99%

The efficacy and safety of intrathecal dexmedetomidine for parturients undergoing cesarean section: a double-blind randomized controlled trial

et al. 2020

Preprint

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Background The efficacy and safety of spinal anesthesia by intrathecal dexmedetomidine (DEX) for parturients undergoing cesarean section are still lack of evidence. This aim of our study was to evaluate the efficacy and safety of intrathecal DEX for parturients undergoing cesarean section to provide more data evidence for intrathecal applications. Methods 300 parturients undergoing cesarean section under spinal anesthesia from two centers were randomly assigned into 3 groups : group B: 9.0 mg (1.2 ml) of bupivacaine 0.75% with saline (1 ml) ; group FB: 9.0 mg (1.2 ml) of bupivacaine 0.75% with 20 µg of fentanyl (1 ml) ; group DB : 9.0 mg (1.2 ml) of bupivacaine 0.75% with 5 µg of DEX (1 ml). Intraoperative block characteristics, parturients’ postoperative quality of recovery, maternal and neonatal outcomes and the plasma concentration of DEX were measured. All parturients were followed up for 30 days to determine whether nerve injury occurred. Results Compared with group B, the duration of sensory block in group FB and group DB were significantly prolonged (108.4 min [95% Confidence Interval (CI) = 104.6-112.3] in group B, and 122.0 min [95% CI = 116.8-127.3] in group FB, 148.2 min [95% CI = 145.3-151.1] in group DB). The overall score of quality recovery in group DB (71.6 [95% CI = 71.0-72.2]) was significantly higher than that in group FB (61.5 [95% CI = 60.8–62.2]) and group B (61.7 [95% CI = 61.0-62.4]). There were no statistically significant among the 3 groups for PH, PaO2, and PaCO2 in the umbilical artery and umbilical vein blood of newborn. The concentration of DEX in umbilical artery and umbilical vein was too low to be detected. The 30-days follow-up of parturients did not show any new onset of back, buttock or leg pain or paresthesia. Conclusion DEX is a potential local anesthetics adjuvant and the combination of 5 µg of DEX can exhibit a facilitatory effect when administered intrathecally as part of spinal anesthesia. However, large sample clinical studies to support the safety of intrathecal DEX use in the clinical setting are still needed. Trial registration : Chinese Clinical Trail Registry (Registration number # ChiCTR1900022019; Date of Registration on March 20th, 2019).

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Evaluation of the Obstetric Quality-of-Recovery score (ObsQoR-11) following non-elective caesarean delivery

Cited by 43 publications

References 26 publications

Evaluation of Domains of Patient-Reported Outcome Measures for Recovery After Childbirth

Evaluation of Domains of Patient-Reported Outcome Measures for Recovery After Childbirth

Evaluation of inpatient postpartum recovery using the Obstetric Quality of Recovery-10 patient-reported outcome measure: a single-center observational study

The efficacy and safety of intrathecal dexmedetomidine for parturients undergoing cesarean section: a double-blind randomized controlled trial

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