The accuracy of reporting of general anaesthesia for childbirth : a validation study

• Published in: Anaesthesia and intensive care Vol. 36; no. 3; pp. 418 - 424
• Main Authors: ROBERTS, C. L, FORD, J. B, LAIN, S, ALGERT, C. S, SPARKS, C. J
• Format: Journal Article
• Language: English
• Published: Edgecliff Anaesthesia and Intensive Care 01.05.2008; Sage Publications Ltd. (UK); Sage Publications Ltd
• Subjects: Adult; Anesthesia; Anesthesia, General - statistics & numerical data; Anesthesia, Obstetrical - statistics & numerical data; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cesarean Section; Data Interpretation, Statistical; Delivery. Postpartum. Lactation; Documentation; Female; General anesthesia; Gynecology. Andrology. Obstetrics; Health aspects; Humans; Medical sciences; Methods; New South Wales - epidemiology; Obstetrical extraction; Practice guidelines (Medicine); Pregnancy; Reproducibility of Results; New South Wales; Australia; general anaesthesia; obstetric delivery; specificity; General anesthesia; Anesthesia; Delivery; sensitivity; administrative data; Obstetrics; caesarean section
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057x0803600313

Administrative population health data, such as hospital discharge data, are a potentially valuable resource for determining anaesthesia and analgesia use in childbirth at a population level. However the reliability of general anaesthesia reporting is unknown. This study aimed to determine the accuracy of the reporting of peripartum general anaesthesia in single and linked population health data. Data from a statewide validation study of 1200 women provided the gold standard for delivery and postpartum general anaesthesia use. The validation data were merged with both the hospital discharge and birth databases. As both of these datasets collect information on general anaesthesia, it could be reported in one, both or neither database. Among the 1184 records available for review, 7.7% of women had a general anaesthetic during the birth admission, of which 6.2% were for delivery and 1.5% were for a postpartum procedure. Reporting sensitivities ranged from 26% to 97% and specificities 94% to 100%. Identifying general anaesthesia from either the birth or hospital data improved general anaesthesia ascertainment. Limiting analysis to caesarean sections resulted in very accurate identification of general anaesthesia for delivery (sensitivity 97.0%, specificity 99.8%) while limiting to vaginal births was moderately accurate for identifying postpartum general anaesthesia (sensitivity 73.2%, specificity 99.8%). General anaesthesia for delivery is reported with a high level of accuracy in birth and linked birth-hospital data, but not in hospital discharge data alone. Population health data are a reliable source for examining general anaesthesia for delivery.