Evaluation of the Obstetric Quality-of-Recovery score (ObsQoR-11) following non-elective caesarean delivery. (August 2019) - Ciechanowicz, S.
Highlights: The ObsQoR-11 scoring tool is a patient-reported outcome measure of recovery. It was developed for use in patients undergoing elective caesarean delivery. We evaluated its use following non-elective caesarean delivery. The ObsQoR-11 performed well in measures of validity, reliability and feasibility. Abstract: 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 vs 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: One hundred 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] vs 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.