The questionnaire was developed in a five-part modular workshop under advice and with the input of interprofessional and interdisciplinary experts. The questionnaire was divided into two parts. The first part was completed by the patient, and the second part by the respective local study investigator. The questionnaire for the patients consisted of 22 items. Patients documented the time of their last preoperative food and fluid intake and, if applicable, the time they last smoked. The time of the patient’s first postoperative food intake and the postoperative use of high calorie drinks were also recorded. In addition, the questionnaire included questions about the patient’s condition during fasting, experience with fasting, the quality of patient education about fasting and subjective perceptions of fasting. While most questions were dichotomous, with one answer option, the items on medical information and subjective beliefs about fasting had the possibility of multiple answers. Questions on condition during fasting were documented via graduated scales. The quality of medical information on fasting was measured via a rating scale. The goal of the questionnaire was to reflect management regarding preoperative fasting from the patient’s perspective. The questionnaire was tested in a run-in phase in ten patients to test understanding and readability.
The second part consisted of the following clinical characteristics and demographic data, that were assessed by the respective study investigators: age, height, weight, surgical procedure, indication for and length of surgery, day of hospital admission, urgency of surgery, chronic disease, medication, American Society of Anesthesiologists Physical Status Classification and Charlson Comorbidity Index.
As the study included a broad spectrum of surgeries, a four-level classification system for the extent of surgery has been designed and applied, ranging from small to moderate, complex and extensive surgery. Small procedures were defined as short open or endoscopic procedures such as hysteroscopies or conizations; moderate procedures were defined as uncomplicated open or endoscopic procedures such as breast conserving surgeries, non-complex laparoscopies or uncomplicated urogynecologic procedures; complex procedures were defined as advanced open or endoscopic procedures such as resection of extensive endometriosis, complex breast reconstruction, complex myomectomy or hysterectomy; extensive procedures were defined as extensive open or endoscopic procedures such as advanced oncologic surgeries, debulking surgery, radical hysterectomy or free flap transplantation. The classification was made by the respective local study investigator.
The second part consisted of the following clinical characteristics and demographic data, that were assessed by the respective study investigators: age, height, weight, surgical procedure, indication for and length of surgery, day of hospital admission, urgency of surgery, chronic disease, medication, American Society of Anesthesiologists Physical Status Classification and Charlson Comorbidity Index.
As the study included a broad spectrum of surgeries, a four-level classification system for the extent of surgery has been designed and applied, ranging from small to moderate, complex and extensive surgery. Small procedures were defined as short open or endoscopic procedures such as hysteroscopies or conizations; moderate procedures were defined as uncomplicated open or endoscopic procedures such as breast conserving surgeries, non-complex laparoscopies or uncomplicated urogynecologic procedures; complex procedures were defined as advanced open or endoscopic procedures such as resection of extensive endometriosis, complex breast reconstruction, complex myomectomy or hysterectomy; extensive procedures were defined as extensive open or endoscopic procedures such as advanced oncologic surgeries, debulking surgery, radical hysterectomy or free flap transplantation. The classification was made by the respective local study investigator.
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