Data collection. Data collection details

Data collection

Overview of data collection is presented in Figure 2. Only admission data, results of diagnostic methods, final diagnosis and hospital survival will be collected for patients in whom AMI was suspected but not confirmed.

Figure 2. Data collection

Data collection details

Baseline data

Demographics

Ethnicity

Gender (M/F)

Age (y)

Weight (kg)

Height (cm)

BMI (kg/m²)

Chronic health conditions

Disability (no need of assistance/needs/No information(NI))

Smoking (yes/no/NI)

Atrial Fibrillation (yes/no/NI)

Atherosclerotic disease (prevalent ischaemic heart disease, stroke, peripheral arterial disease (carotid artery stenosis, lower extremity arterial disease such as claudication or chronic limb-threatening ischaemia/critical limb ischaemia) (yes/no/NI)

Arterial hypertension (yes/no/NI)

Previous myocardial infarction (yes/no/NI)

Previous arterial thromboembolic events (yes/no/NI)

Artificial heart valve (yes/no/NI)

Medications at home

Anticoagulant drugs (yes/no/NI)

Antiplatelet drugs (yes/no/NI)

Statins (yes/no/NI)

Emergency Department (ED) data

Means of arrival to the hospital (by self, ambulance)

Time to arrival at the hospital from the beginning of symptoms (hours (h)/unclear)

Initial diagnosis leading to hospital admission

Type of ED where the patient was initially admitted (surgical/non-surgical/mixed = no separated surgical/non-surgical)

Acute health condition at admission or immediately before the diagnosis of AMI (if AMI suspected/diagnosed later during the hospital stay)

Charlson co-morbidity index with a link to respective calculator

APACHE II (only if patient is hospitalized to the ICU) with a link to respective calculator

New (previously not documented) atrial fibrillation

Cardiac arrest (yes/no, prehospital setting/emergency room/in-hospital)

Mechanical ventilation (initiated in prehospital setting/emergency room)

Vasopressors with maximum dosage within 72h before the diagnosis of AMI

Maximum intra-abdominal pressure within 72h before the diagnosis of AMI

Main symptoms

Symptoms causing hospital admission

Symptoms supporting suspicion of AMI

acute abdominal pain

diarrhoea

bloody stools

shock

other (specify)

Acute conditions (during this hospitalisation) with known risk of AMI

cardiac surgery

aortic surgery

embolisation of mesenteric arteries/branches (e. g. due to bleeding)

shock with high-dose vasopressors (document max dose)

Laboratory tests on hospital admission day or at the time suspicion of AMI arises (if taken)

Lactate (mmol/l/NI)

· highest during 48-72h before the diagnosis of AMI (if applicable)

· highest during 24-48h before the diagnosis of AMI (if applicable)

· highest during 12-24h before the diagnosis of AMI (if applicable)

· highest during 0-12h before the diagnosis of AMI

WBC (x 10E⁹/L/NI), maximal or minimal (most pathologic) within 72 hours before the diagnosis of AMI, if several measurements performed

Creatinine (mcmol/l/NI), maximal within 72 hours before the diagnosis of AMI, if several measurements performed

eGFR (mL/min/1, 73m27/NI), minimal within 72 hours before the diagnosis of AMI, if several measurements performed

pH, minimal within 72 hours before the diagnosis of AMI, if several measurements performed

BE (mmol/l/NI), worstwithin 72 hours before the diagnosis of AMI, if several measurements performed

ASAT (U/L/NI), maximal within 72 hours before the diagnosis of AMI, if several measurements performed

Amylase (U/L/NI), maximal within 72 hours before the diagnosis of AMI, if several measurements performed

C-reactive protein (mg/L)

D-dimers (mg/L/NI), maximal within 72 hours before the diagnosis of AMI, if several measurements performed

Troponin T (ng/L/NI), maximum within 72 hours before the diagnosis of AMI, if several measurements performed

AMI event data

AMI occurred during hospital treatment (Y/N) If YES here, answer specific questions:

Location in the hospital (medical ward, surgical ward, HDU, ICU, other)

Time from hospital admission until suspicion of AMI (days, h if < 24h)

Time from hospital admission (from suspicion of AMI if AMI occurred during the hospital stay) to CT-scan (h)

Time from beginning of symptoms to diagnosis of AMI (h)

Specialty of physician performing the first evaluation after beginning of symptoms (surgery, medicine, emergency medicine, critical care, other)

Time from arrival to the hospital to diagnosis of AMI (in ED patients)(h)

AMI was admission diagnosis in case of referral from another hospital (patient referred for treatment) (Y/N)

Surgery during the hospital stay before diagnosis of AMI

Factors leading to delay in diagnosis (high workload, nonspecific symptoms, normal lactate value, insufficient experience regarding AMI of the first specialist, no predisposing factors identified, other (specify))

Radiological imaging

What was the first radiographic study (x-ray, US, CT, other, none)

Was AMI suspected in the referral for first radiographic study?

Was a CT-scan performed (yes/no)

Phases of enhancement in CT-scan (no contrast media, portal venous, arterial,

delayed phase)

Radiologist diagnosed AMI (yes/no/uncertain)

Time between CT-scan and the response by radiologist (min)

Type of AMI

arterial embolism (localization)

arterial thrombosis (localization)

arterial non-specified (localization)

venous (localization)

NOMI (localization)

Mechanical compression

Other/Unclear (localization)

Management data

Treatment options NOT available at the time of diagnosis

endovascular revascularisation

intra-arterial vasodilation

other (specify)

Treatment options discussed within the team (multiple options possible)

exploratory laparotomy

endovascular revascularisation

endovascular revascularisation followed by open visceral surgery

open surgical revascularisation with or without intestinal resection

Intestinal resection without revascularisation

intra-arterial vasodilation

palliation

other (specify)

Treatment options discussed with patient and family

exploratory laparotomy

endovascular approach

open surgery

endovascular approach plus surgery

palliation

Initial treatment of AMI

Time from beginning of symptoms to each specific treatment of AMI (h)

Time from presentation (arrival at the hospital) to treatment (h)

Time from diagnosis to treatment (h)

Surgical management (explorative laparoscopy, explorative laparotomy, therapeutic

laparotomy, damage control)

Surgical revascularization (embolectomy, thrombectomy, endarterectomy,

aortomesenteric shunt, ROMS, other)

Endovascular treatment (aspiration of thrombus/embolism, balloon dilatation,

stenting, thrombolysis, intraarterial vasodilation, other, combined)

Gastrointestinal tract surgical management (no need, resection with primary anastomosis, resectionwith stoma formation, resection without anastomosis and planned second look)

Small intestinal resection (cm/NI)

Length of residual small intestine (cm/> 200cm/NI)

Resection of colon (no need, right hemicolectomy, left hemicolectomy or sigmoid resection subtotal or total colectomy, other)

Open abdomen (yes/no)

Conservative treatment (yes/no)

End-of-life care

Later surgical treatment

Pre-planned second-look laparotomy

Number of re-operations

Number of other interventions (specify)

Time to closure if open abdomen

Systemic treatment after diagnosis/treatment of AMI (after treatment of AMI, or diagnosis of AMI if no specific intervention was applied (e. g. NOMI without mesenteric infarction))

SOFA score with all subscores separately (only if patient is hospitalized to the ICU)

Vasopressors (maximum dosage during 48h)

Fluids(total i/v fluids and maximum positive fluid balance during 48h after treatment of AMI)

Mechanical ventilation (yes/no, days)

Renal replacement therapy (yes/no, days)

Nutrition (oral/enteral/parenteral/combined/none, total calories within 48h)

Anticoagulation(specific medication and maximal target dosage within 48h)

Antiplatelet therapy (specific medications)

Histology data on (if available)

Sample from initial operation/reoperation

transmural necrosis present

only mucosal necrosis present

other (specify)

Outcome data

Only hospital survival and no other outcomes will be documented for patients with suspected but not confirmed AMI.

For patients with confirmed AMI, the following outcome data will be collected:

· at hospital discharge: hospital survival, hospital stay, ICU stay, duration of parenteral nutrition (PN) in hospital, home PN initiated, stoma

· at 30 days: survival

· at 90 days: survival, home PN, stoma

· at 1 year: survival, physical independency/quality of life (EQ-5D-5L) (11).

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