EAST Multicenter Study
Data Collection tool
Multicenter Study: ______
Enrolling Center:______
Enrolling Co-investigator:______
Demographics / Injury Variables:
Age:______Gender:______
Mechanism of initial injury:
Blunt: YES / NO
Penetrating: YES / NO
ISS: ______AIS Head: ______AIS Chest: ______AIS Abdomen: ______
Admission Lab values:
Hemoglobin: ______pH: ______INR: ______Lactate: ______Base Deficit: ______
Management Variables:
Time from injury to initial operation (in hours): ______
Indication for use of open abdominal management (check one that best applies)
______Damage control
______To facilitate early re-exploration and urgent/emergent re-evaluation
(i.e. assessment of bowel viability)
______Decompression of abdomen in setting of elevated ICP
______Other:______
Operative variables at time of laparotomy:
Peri-operative antibiotics (defined as antibiotics initiated during operation or started within 24 hours after the completion of initial procedure) (Circle one): Yes No (Type:______)
Blood loss:______cc
Intra-operative crystalloid given:______cc
Total Intra-operative blood products given:______cc
PRBC volume:______cc
FFP volume:______cc
Platelet volume:______cc
Intra-operative non-blood colloid given:______cc
Total fluid balance from OR______cc
Damage control indicators present during operation? (Check all that apply)
______Clinical coagulopathy
______Acidosis (pH?______)
______Hypothermia (temp < 35 C)
Operative interventions at time of laparotomy (check all that apply):
______Abdominal Packing: YES / NO Number of packs: ______
______Gastric Injury Repair / Resection
______Diaphragm Injury Repair
______Bowel resection?
Type / number of resections:______
Left in discontinuity? (Circle) YES NO
______Hepatic intervention?
(TYPE: Circle: Hepatorapphy, Packing, Resection (Type):______)
______Splenectomy
______Nephrectomy
______Vascular Injury repair? LOCATION:______
TYPE:______
______Posteriorlateral Thoracotomy
______Anteriolateral Thoracotomy EDT? (Circle One:) YES NO
______Other operative interventions:______
What was the type of temporary closure utilized?
______Witttman patch
______Negative Pressure (NPWT)
______KCI product? Type:______
______Non-commercial apparatus
Negative pressure setting utilized: ______mm/Hg
Continuous NPWT: YES / NO
Intermittent NPWT: YES / NO
______Other:______
Post-operative course:
Fluid requirements first 24 hours after surgery (total fluids):______cc
Colloid:______cc
Crystalloid:______cc
Fluid requirements first 48 hours after surgery (total fluids):______cc
Colloid:______cc
Crystalloid:______cc
Time to first re-exploration:______
Total number of re-explorations:______
Average interval between re-explorations:______
Time to normalization of Lactate? (Hours)______
Where antibiotics utilized post-operatively (circle one): NoYes Type:______
Dosing interval:______
Duration of use:______
Mechanical Ventilation:
Ventilation mode utilized post-operatively:______
Maximum Peak Airway pressure observed:______
When was enteral feeding imitated? HD#______
Did the patient develop ileus or feeding intolerance? (Circle One): YES NO
When did the patient reach goal enteral nutrition feeding rates? HD#______
Was a tracheostomy required? YES NO Hospital Day #______
Outcomes:
Fascial Closure attempt during initial hospitalization? (Circle one:)YESNO
If Yes, what type of closure was utilized (check the one that applies)
______Primary fascial closure
______Wittman patch to primary closure
______Synthetic Mesh? Type:______
______Biosynthetic / Biologic Mesh? Type:______
Circle management of biologic mesh that applies:
1.Covered with wound vac – discharged with vac
2.Covered initially with vac – skin closure same hospitalization
3.Skin closure over biologic at initial closure operation
______Separation of components
______Other:______
When was fascial closure achieved (HD#______)
Results of Fascial Closure: (check as applies)
______No complication
______Re-exploration required for:______Abdominal compartment syndrome
______Abdominal sepsis
______Dehiscence / Early repair failure
______Other:______
Complications: (check all that apply and list Hospital Day encountered)
______Enteric fistula HD #______
______Hospital Acquired Pneumonia HD #______
______VAP HD #______
______BSI HD #______
______Catheter associated UTIHD #______
______Sepsis HD #______
______Intra-abdominal abscess / sepsis HD #______
______DVT / PE HD #______
______Acute Renal Failure (Cr >2.0) HD #______
______ALI / ARDS HD #______
Hospital LOS: ______ICU LOS:______
Ventilator Days:______Mortality (circle one): YES NO
Mortality within 48 hours of admission?
YES NO