AIF Questionnaire
Acute Intestinal Failure Special Interest Group

Dear Sir / Madam
Re: European survey of high output enterocutaneous fistula management

The European Society of Parenteral and Enteral Nutrition (ESPEN) has a special interest group which
wishes to optimise both the provision and management of acute intestinal failure in Europe. The first
step in this goal is to develop a network of the hospitals and teams that have developed an interest in
treating this condition.
We appreciate that there are many different calls on your time, but we hope that you will be able to
complete the attached 2 page questionnaire and return to the address below. By participating in this
survey you can become part of a European clinical network for acute intestinal failure. Such a network
will enable shared protocols as well as research and educational programs.
You have received this questionnaire as it has been suggested that you manage patients with high
output enterocutaneous fistulae. In particular, we wish to gather information on some of the
differences in the facilities and management of patients with high output enterocutaneous fistulae
resulting in intestinal failure. We know already that different countries have very different healthcare
structures and this is likely to result in differences in patient types as well as different management
If you have received this by email then you will have received 2 versions: a PDF and a word
document. If you wish to print it out then the PDF is the most reliable. This can then be completed
and then scanned and emailed / faxed / posted. If it is easier for you to complete on the computer
then open the word document and save on your computer. This can then be emailed back to us.
We plan to present the results of this questionnaire at the next ESPEN Congress in Barcelona in
September 2012. We can assure you that all published results will be anonymised and, if required,
the results can be sent out to you directly.
Thank you for taking the time to complete this survey. Please return to:
Dr Simon Gabe
Dr Jon Shaffer
Yours sincerely Simon Gabe and Jon Shaffer On behalf of the ESPEN Acute Intestinal Failure Special Interest Group A European survey to assess the management of patients with
high output enterocutaneous fistulae

ESPEN Acute Intestinal Failure SIG
About your hospital
Discipline (eg nurse, dietitian, pharmacist) About your centre / unit
Do you care for patients with a high output enterocutaneous fistula?
Do you accept referrals from other centres? Yes / No - combined medical and surgical ward - dedicated intestinal failure unit Do you have a multidisciplinary nutrition team?
What population do you receive patients from?
Local Regional National
Aetiology of enterocutaneous fistulae
Do you have a database relating to these
For your current inpatients, how many have the
following conditions resulting in the
development of enterocutaneous fistulae?

Management of enterocutaneous fistulae
What do you consider to be a meaningful high
output fistula?

In patients with a newly developed enterocutaneous fistula
a) Do you have a policy which includes fluid & food restriction? b) At what point in time do you allow a patient to: In patients with a non-spontaneously healing enterocutaneous fistula
a) Do you have a policy which includes fluid & food restriction? b) At what point in time do you allow a patient to: In patients with a high output fistula, do you use?
Do you ever try to feed patients distally? (If yes, how many patients over the past year?)
How many enterocutaneous fistula resections / repairs have been performed in the
past 12 months in your unit?
In a patient with an enterocutaneous fistula:
a) Do you have a policy on when to operate? _____ weeks / months (delete as appropriate) Send the patient back to the referring hospital d) Does the timing of surgery depend on the cause Do you have the expertise in your centre to manage these patients on home
parenteral nutrition until surgery can be performed?
In the past 12 months have you used any of the following in the surgical treatment of
enterocutaneous fistulae?

a) Abdominal wall meshes to close the abdomen? b) Component separation to close the abdomen Training & outcomes
Do you and your multidisciplinary team feel that you have had appropriate training in
management of patients with a high output enterocutaneous fistula?

What is the re-fistulation rate in your unit after corrective surgery in the past year?
How many of your current inpatients have a recurrent fistula?
17 Do the current coding systems in your country account for the complexity of the
surgery performed in these patients?
18 Is there appropriate financial remuneration for the care of these patients:


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