RT Journal Article
SR Electronic
T1 A core outcome set for damage control laparotomy via modified Delphi method
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e000821
DO 10.1136/tsaco-2021-000821
VO 7
IS 1
A1 Saskya Byerly
A1 Jeffry Nahmias
A1 Deborah M Stein
A1 Elliott R Haut
A1 Jason W Smith
A1 Rondi Gelbard
A1 Markus Ziesmann
A1 Melissa Boltz
A1 Ben L Zarzaur
A1 Miklosh Bala
A1 Andrew Bernard
A1 Scott Brakenridge
A1 Karim Brohi
A1 Bryan Collier
A1 Clay Cothren Burlew
A1 Michael Cripps
A1 Bruce Crookes
A1 Jose J Diaz
A1 Juan Duchesne
A1 John A Harvin
A1 Kenji Inaba
A1 Rao Ivatury
A1 Kevin Kasten
A1 Jeffrey D. Kerby
A1 Margaret Lauerman
A1 Tyler Loftus
A1 Preston R. Miller
A1 Thomas Scalea
A1 D Dante Yeh
YR 2022
UL http://tsaco.bmj.com/content/7/1/e000821.abstract
AB Objectives Damage control laparotomy (DCL) remains an important tool in the trauma surgeon’s armamentarium. Inconsistency in reporting standards have hindered careful scrutiny of DCL outcomes. We sought to develop a core outcome set (COS) for DCL clinical studies to facilitate future pooling of data via meta-analysis and Bayesian statistics while minimizing reporting bias.Methods A modified Delphi study was performed using DCL content experts identified through Eastern Association for the Surgery of Trauma (EAST) ‘landmark’ DCL papers and EAST ad hoc COS task force consensus.Results Of 28 content experts identified, 20 (71%) participated in round 1, 20/20 (100%) in round 2, and 19/20 (95%) in round 3. Round 1 identified 36 potential COS. Round 2 achieved consensus on 10 core outcomes: mortality, 30-day mortality, fascial closure, days to fascial closure, abdominal complications, major complications requiring reoperation or unplanned re-exploration following closure, gastrointestinal anastomotic leak, secondary intra-abdominal sepsis (including anastomotic leak), enterocutaneous fistula, and 12-month functional outcome. Despite feedback provided between rounds, round 3 achieved no further consensus.Conclusions Through an electronic survey-based consensus method, content experts agreed on a core outcome set for damage control laparotomy, which is recommended for future trials in DCL clinical research. Further work is necessary to delineate specific tools and methods for measuring specific outcomes.Level of evidence V, criteriaAll data relevant to the study are included in the article or uploaded as supplementary information.