Department of Obstetrics and Gynaecology, Westmead Hospital, Sydney, New South Wales, Australia.
The Wollongong Hospital, Wollongong, New South Wales, Australia.
Int J Med Inform. 2018 Dec;120:42-49. doi: 10.1016/j.ijmedinf.2018.09.020. Epub 2018 Sep 28.
Data related to postpartum haemorrhage (PPH) are important clinical parameters which can be applied to all places of birth, and their recording can be missed by busy clinicians providing critical care to women. We compared the accuracy of electronic ObstetriX records to the paper-based medical records of the women who sustained PPH.
In this retrospective cohort study over a period of one month, 363 electronic records were compared to the paper-based medical records. The volume of blood loss for each patient and interventions for PPH were compared across birth unit, operating theatre and postpartum ward. The kappa statistic for agreement between the two types of recording methods was calculated.
There was substantial agreement between the ObstetriX records and medical records for the volume of blood loss at birth (kappa = 0.74), but poor agreement between records for the cumulative total volume of blood loss (kappa = 0.18). More women who experienced PPH and delivered in the operating theatre had errors in their ObstetriX records compared to women who had PPH with births in the birth unit (50% vs 16%; n = 73, P = 0.005). Interventions for PPH were found to be poorly recorded in ObstetriX, with 84% (n = 64/76) of women who experienced PPH having none of the interventions they received recorded.
The ObstetriX database was not a generally reliable source of data relating to PPH. However, some data were recorded reliably, in particular, the volume of blood loss at birth.
产后出血（PPH）相关数据是重要的临床参数，可应用于所有分娩场所，但其记录可能会被忙于为妇女提供重症监护的忙碌临床医生遗漏。我们比较了电子 ObstetriX 记录与发生 PPH 的妇女的纸质病历的准确性。
在为期一个月的回顾性队列研究中，将 363 份电子记录与纸质病历进行了比较。比较了各产妇在分娩单元、手术室和产后病房的失血量和 PPH 干预措施。计算了两种记录方法之间的一致性kappa 统计量。
ObstetriX 记录与病历在分娩时的失血量方面具有高度一致性（kappa=0.74），但累计失血量记录之间的一致性较差（kappa=0.18）。与分娩单元分娩的发生 PPH 的女性相比，在手术室分娩并发生 PPH 的女性的 ObstetriX 记录中存在更多错误（50%对 16%；n=73，P=0.005）。ObstetriX 中发现 PPH 干预措施记录不佳，经历 PPH 的 84%（n=64/76）的女性没有记录她们接受的任何干预措施。
ObstetriX 数据库并不是与 PPH 相关数据的可靠来源。然而，一些数据记录可靠，特别是分娩时的失血量。
