Evaluation of the Obstetric Quality-of-Recovery score (ObsQoR-11) following non-elective caesarean delivery. International journal of obstetric anesthesia Ciechanowicz, S., Howle, R., Heppolette, C., Nakhjavani, B., Carvalho, B., Sultan, P. 2019


BACKGROUND: Few robust scoring tools exist to assess recovery following caesarean delivery (CD). We evaluated a new obstetric quality of recovery score (ObsQoR-11, initially formulated for elective CD) following non-elective CD.METHODS: ObsQoR-11 questionnaires were completed by women at day one post non-elective CD. Convergent validity was assessed by correlation of ObsQoR-11 with a 100?mm numerical rating scale (NRS) of general health status; discriminant validity by correlation with good versus poor recovery (NRS of =70 vs. <70?mm, respectively); and content validity by correlation with length of stay (LOS), CD category, parity, gestation, previous CD, duration, blood loss, haemoglobin, age and body mass index. Cronbach's alpha, inter-item, split-half and test-retest correlation assessed reliability. Feasibility was tested by recruitment rate and time for ObsQoR-11 completion.RESULTS: 100 women completed ObsQoR-11 at 24?h and 20 women repeated it at 25?h. ObsQoR-11 correlated strongly with NRS (r?=?0.72 [95% CI 0.61 to 0.81], P?<0.0001); discriminated well between good versus poor recovery (median [IQR] score 97 [86.5-101] versus 64 [50.5-78.5], P?<0.0001); correlated to LOS (r?=?-0.24 [-0.42 to -0.04], P=0.02) and parity (r?=?0.24 [0.04 to 0.42], P=0.02). Reliability was acceptable: Cronbach's alpha 0.75; inter-item correlation >0.15; split-half reliability 0.96; and intra-class correlation >0.6; no floor or ceiling effects. One hundred percent completed the ObsQoR-11 (median [IQR] completion time 117 [89-156] s).CONCLUSIONS: ObsQoR-11 is valid and reliable in assessing recovery after non-elective CD. Further research should assess generalisability and use following vaginal delivery.

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