Quality of Recovery From Obstetric Anaesthesia - a Multicentre Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Obstetric Anesthesia Problems
- Sponsor
- Guy's and St Thomas' NHS Foundation Trust
- Enrollment
- 1638
- Locations
- 1
- Primary Endpoint
- • Correlation of ObsQoR with length of hospital stay (LOS) in hours following delivery across multiple centres, particularly ObsQoR score and prediction of prolonged LOS (>1.5 SD) and readmission to hospital.
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
Quality of recovery is an important outcome measure in anaesthesia, whilst there are validated tools for this in surgery and regional anesthesia there are no fully validated tools for obstetrics anaesthesia. The aim of this study is to use the Obstetric Quality of Recovery (ObsQoR) score across multiple centres to assess correlation to length of stay and variation for different types of operative and non- operative delivery.
Detailed Description
An observational survey based study, for 3 consecutive week days, chosen by the local investigating team during a two-week period across multiple centres. * Local investigators will complete the survey with each patient who has received anaesthetic intervention from an anaesthetist, 1 day, around 24hrs after delivery in line with their routine anaesthetic follow up. * At 30 days, a telephone survey will be conducted with each patient to repeat the ObsQoR survey and ask key questions regarding functional recovery and activities of daily living post delivery. In addition for a small number of sites, elective caesarean delivery patients will have blood taken at the point of anaesthesia and 24 hours post delivery to assess the immune function and any changes which may predict poorer outcome in these women.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Obstetric patients over 18 years old.
- •Intervention occurring after 32/40 gestation.
- •All mothers receiving anaesthesia or anaesthetic analgesia during their peripartum period.
Exclusion Criteria
- •Unable to comprehend the questions asked
- •Patient refusal
- •Under 32/40 weeks gestation
- •Cervical cerclage insertion or removal, anaesthesia for External Cephalic Verison
- •Neonatal death
- •Non- NHS patients
Outcomes
Primary Outcomes
• Correlation of ObsQoR with length of hospital stay (LOS) in hours following delivery across multiple centres, particularly ObsQoR score and prediction of prolonged LOS (>1.5 SD) and readmission to hospital.
Time Frame: Up to 3 months
During the study the total length of stay in hours will be calculated for participating patients. This will be correlated with the score from the ObsQoR survey tool. In addition the readmission status of the patient will be asked at the subsequent survey combined with the patient's health care record to correlate with the ObsQoR tool score. Where the ObsQoR score is measured between 0-100 and LOS will be in hours. Readmission will be a binary outcome measure
• The relationship between ObsQoR and patient-reported ready for discharge. This will concurrently be determined to account for institutional, non-medical maternal factors neonatal factors that may delay discharge and impact LOS.
Time Frame: up to 3 months
The patient will be surveyed using the ObsQoR tool and also asked regarding when they felt they were ready for discharge to take into account the multitude of factors which may impact on the overall length of stay. Where the ObsQoR score is measured between 0-100 and LOS will be in hours.
Secondary Outcomes
- • Comparing ObsQoR profiles with differing types of obstetric anaesthesia and delivery method.(up to 3 months)
- • Variations in ObsQoR scores across differing centres.(up to 3 months)
- • Impact of patient factors on ObsQoR score.(up to 3 months)
- • Impact of anaesthetic or obstetric factors on ObsQoR score.(up to 3 months)
- • Impact of neonatal facts on ObsQoR score.(up to 3 months)
- • Impact of institutional factors on ObsQoR score.(up to 3 months)
- • Impact of time of day on ObsQoR score.(up to 3 months)
- • Impact of anaesthesia provider factors on ObsQoR score.(up to 3 months)
- • Prediction of patients who are likely to have an ongoing requirement for analgesia.(up to 3 months)
- • Prediction of patients who are likely to require further follow up in the community or investigation.(up to 3 months)
- • Prediction of patients' ability to return to normal activities of daily living.(up to 3 months)
- • Prediction of patients' who are unable to achieve adequate activity levels. As determined by number of steps on mobile phone / activity tracker.(up to 3 months)
- Assessment of perioperative immune function and response to surgical trauma as a predictor of outcome following elective caesarean delivery.(up to 3 months)
- Assessment of correlation between ObsQoR scores, EQ-5D and global health visual analogue scale results at 24 hours and 30 days.(up to 30 days)