Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Department of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Anaesthesia. 2023 Sep;78(9):1071-1080. doi: 10.1111/anae.16039. Epub 2023 May 24.
To better understand outcomes in postpartum patients who receive peripartum anaesthetic interventions, we aimed to assess quality of recovery metrics following childbirth in a UK-based multicentre cohort study. This study was performed during a 2-week period in October 2021 to assess in- and outpatient post-delivery recovery at 1 and 30 days postpartum. The following outcomes were reported: obstetric quality of recovery 10-item measure (ObsQoR-10); EuroQoL (EQ-5D-5L) survey; global health visual analogue scale; postpartum pain scores at rest and movement; length of hospital stay; readmission rates; and self-reported complications. In total, 1638 patients were recruited and responses analysed from 1631 (99.6%) and 1282 patients (80%) at one and 30 days postpartum, respectively. Median (IQR [range]) length of stay postpartum was 39.3 (28.5-61.0 [17.7-513.4]), 40.3 (28.5-59.1 [17.8-220.9]), and 35.9 (27.1-54.1 [17.9-188.4]) h following caesarean, instrumental and vaginal deliveries, respectively. Median (IQR [range]) ObsQoR-10 score was 75 ([62-86] 4-100) on day 1, with the lowest ObsQoR-10 scores (worst recovery) reported by patients undergoing caesarean delivery. Of the 1282 patients, complications within the first 30 days postpartum were reported by 252 (19.7%) of all patients. Readmission to hospital within 30 days of discharge occurred in 69 patients (5.4%), with 49 (3%) for maternal reasons. These data can be used to inform patients regarding expected recovery trajectories; facilitate optimal discharge planning; and identify populations that may benefit most from targeted interventions to improve postpartum recovery experience.
为了更好地了解接受围产期麻醉干预的产后患者的结局,我们旨在通过一项英国多中心队列研究评估分娩后患者的恢复质量。这项研究于 2021 年 10 月的两周内进行,以评估分娩后 1 天和 30 天的门诊和住院恢复情况。报告了以下结果:产科恢复质量 10 项测量量表(ObsQoR-10);欧洲五维健康量表(EQ-5D-5L)调查;全球健康视觉模拟量表;休息和活动时的产后疼痛评分;住院时间;再入院率;以及自我报告的并发症。共招募了 1638 名患者,分别有 1631 名(99.6%)和 1282 名(80%)患者在产后 1 天和 30 天时进行了分析。产后住院时间中位数(IQR [范围])分别为剖宫产、器械分娩和阴道分娩后 39.3(28.5-61.0 [17.7-513.4])、40.3(28.5-59.1 [17.8-220.9])和 35.9(27.1-54.1 [17.9-188.4])小时。术后第 1 天的 ObsQoR-10 评分中位数(IQR [范围])为 75(62-86] [4-100]),剖宫产患者报告的 ObsQoR-10 评分最低(恢复最差)。在 1282 名患者中,有 252 名(19.7%)患者在产后 30 天内报告了并发症。出院后 30 天内再次入院的患者有 69 名(5.4%),其中 49 名(3%)为产妇原因。这些数据可用于告知患者预期的恢复轨迹;促进最佳出院计划;并确定最受益于针对性干预措施以改善产后恢复体验的人群。