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 Byerly, Saskya
A1 Nahmias, Jeffry
A1 Stein, Deborah M
A1 Haut, Elliott R
A1 Smith, Jason W
A1 Gelbard, Rondi
A1 Ziesmann, Markus
A1 Boltz, Melissa
A1 Zarzaur, Ben L
A1 Bala, Miklosh
A1 Bernard, Andrew
A1 Brakenridge, Scott
A1 Brohi, Karim
A1 Collier, Bryan
A1 Burlew, Clay Cothren
A1 Cripps, Michael
A1 Crookes, Bruce
A1 Diaz, Jose J
A1 Duchesne, Juan
A1 Harvin, John A
A1 Inaba, Kenji
A1 Ivatury, Rao
A1 Kasten, Kevin
A1 Kerby, Jeffrey D.
A1 Lauerman, Margaret
A1 Loftus, Tyler
A1 Miller, Preston R.
A1 Scalea, Thomas
A1 Yeh, D Dante
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.