Though the rate of general anesthesia (GA) in lieu of neuraxial anesthesia (NA) for
cesarean delivery (CD) continues to decline, variability in type of anaesthesia used
has been shown across patient demographics and hospital resource levels.
1
We read with great interest the study by Singh et al.,
2
which showed that each point increase on the obstetric comorbidity index (OB-CMI)
- Singh S.
- Farber M.K.
- Bateman B.T.
- et al.
Obstetric comorbidity index and the odds of general vs. Neuraxial anesthesia in women
undergoing cesarean delivery: a retrospective cohort study.
Int J Obstet Anesth. 2022; 51103546https://doi.org/10.1016/j.ijoa.2022.103546
3
was associated with increased odds of GA compared with NA for CD in a single-center
population. We aimed to expand upon the Singh et al. study by comparing the performance
of models with patient- and hospital-level characteristics. We hypothesized that in
a multicenter setting, a model including hospital-level covariates would exhibit superior
performance in accurately predicting the use of GA than models with patient-level
covariates alone.To read this article in full you will need to make a payment
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References
- The current role of general anesthesia for cesarean delivery.Curr Anesthesiol Rep. 2021; 11: 18-27https://doi.org/10.1007/s40140-021-00437-6
- Obstetric comorbidity index and the odds of general vs. Neuraxial anesthesia in women undergoing cesarean delivery: a retrospective cohort study.Int J Obstet Anesth. 2022; 51103546https://doi.org/10.1016/j.ijoa.2022.103546
- Development of a comorbidity index for use in obstetric patients.Obstet Gynecol. 2013; 122: 957-965https://doi.org/10.1097/AOG.0b013e3182a603bb
- Validation of an obstetric comorbidity index in an external population.BJOG. 2015; 122: 1748-1755https://doi.org/10.1111/1471-0528.13254
- Effect of hospital safety-net burden on cost and outcomes after surgery.JAMA Surg. 2016; 151: 120-128https://doi.org/10.1001/jamasurg.2015.3209
- Patient race and racial composition of delivery unit associated with disparities in severe maternal morbidity: a multistate analysis 2007–2014.Int J Obstet Anesth. 2021; 47103160https://doi.org/10.1016/j.ijoa.2021.103160
- Comparative assessment of three common algorithms for estimating the variance of the area under the nonparametric receiver operating characteristic curve.Stata J. 2002; 2: 280-289https://doi.org/10.1177/1536867x0200200304
- Assessing the calibration of dichotomous outcome models with the calibration belt.Stata J. 2017; 17: 1003-1014https://doi.org/10.1177/1536867x1701700414
Article info
Publication history
Published online: February 01, 2023
Accepted:
January 25,
2023
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
