ID

41941

Description

To be completed for patients receiving critical care on whom the data below are available, together with the RAPID CRF. RAPID COVID-19 CRF users: - Sites should select whether they complete Part A only or both Parts A & B where resources allows. - In addition always complete the RAPID CRF Module 1 on day of admission to the hospital. For patients receiving critical care complete: - Part A - Complete on every day for patients receiving critical care beginning on the day of admission to an intensive care / high dependency unit, or on the first day of deterioration to severe disease in any ward where the data below is available. Complete daily for as many days as resources allow. In addition, complete the RAPID CRF Module 2 (Daily Form). - Part B - Complete Section 1 on the day of admission to an intensive care / high dependency unit. Complete Section 2 every day during critical care. In addition, complete the RAPID CRF Module 2 (Daily Form). - Complete the RAPID CRF Module 3 on death or hospital discharge for all patients.

Keywords

  1. 2/18/21 2/18/21 -
Copyright Holder

ISARIC on behalf of Oxford University

Uploaded on

February 18, 2021

DOI

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License

Creative Commons BY-SA 4.0

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ISARIC/WHO Novel Coronavirus (nCoV) / COVID-19 Case Report Form

COVID-19 Case Report Form Rapid Critical Care Module - Part B

Participant Identification Numbers
Description

Participant Identification Numbers

Alias
UMLS CUI-1
C3165543
Participant Identification Numbers
Description

Participant Identification Numbers consist of a 3 digit site code and a 4 digit participant number. You can obtain a site code and registering on the data management system by contacting ncov@isaric.org. Participant numbers should be assigned sequentially for each site beginning with 0001. In the case of a single site recruiting participants on different wards, or where it is otherwise difficult to assign sequential numbers, it is acceptable to assign numbers in blocks or incorporating alpha characters. E.g. Ward X will assign numbers from 0001 or A001 onwards and Ward Y will assign numbers from 5001 or B001 onwards. Enter the Participant Identification Number at the top of every page.

Data type

text

Alias
UMLS CUI [1]
C3165543
ICU/HDU Admission Form
Description

ICU/HDU Admission Form

Alias
UMLS CUI-1
C0583239
UMLS CUI-2
C1301858
ICU admission date (DD/MM/YYYY):
Description

ICU admission date

Data type

date

Alias
UMLS CUI [1,1]
C0583239
UMLS CUI [1,2]
C1302393
Enrolment in interventional clinical study?
Description

Enrolment in interventional clinical study

Data type

integer

Alias
UMLS CUI [1,1]
C1516879
UMLS CUI [1,2]
C3274035
If YES, name of study:
Description

Fill in this item or the following one.

Data type

integer

Alias
UMLS CUI [1,1]
C1516879
UMLS CUI [1,2]
C3274035
UMLS CUI [1,3]
C2348560
Treatment/s trialled:
Description

Treatment/s trialled

Data type

text

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C3274035
Name of study or trialled treatment unknown
Description

Name of study or trialled treatment unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C3274035
UMLS CUI [1,3]
C0439673
UMLS CUI [2,1]
C3274035
UMLS CUI [2,2]
C0439673
UMLS CUI [2,3]
C2348560
Reason for ICU admission (tick all that apply):
Description

Reason for ICU admission (tick all that apply):

Alias
UMLS CUI-1
C0392360
UMLS CUI-2
C0583239
Respiratory failure
Description

Reason for ICU admission: Respiratory failure

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C1145670
Septic shock
Description

Reason for ICU admission: Septic shock

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C0036983
Venous thromboembolism
Description

Reason for ICU admission: Venous thromboembolism

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C1861172
Cardiovascular complications
Description

Reason for ICU admission: Cardiovascular complications

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C0007226
UMLS CUI [1,4]
C0009566
Acute kidney injury
Description

Reason for ICU admission: Acute kidney injury

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C2609414
Acute liver injury
Description

Reason for ICU admission: Acute liver injury

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C2242583
Neurological complications
Description

Reason for ICU admission: Neurological complications

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C0235029
Secondary infection
Description

Reason for ICU admission: Secondary infection

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C0442886
Pancreatic injury
Description

Reason for ICU admission: Pancreatic injury

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C0010957
UMLS CUI [1,4]
C0030274
Disseminated intravascular coagulation
Description

Reason for ICU admission: Disseminated intravascular coagulation

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C0012739
Pregnancy related complications
Description

Reason for ICU admission: Pregnancy related complications

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C0032962
Rhabdomyolysis
Description

Reason for ICU admission: Rhabdomyolysis

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C0035410
Other reason for ICU admission
Description

Other reason for ICU admission

Data type

boolean

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C0392360
UMLS CUI [1,3]
C0583239
Other - please specify:
Description

Other reason for ICU admission - specification

Data type

text

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C0392360
UMLS CUI [1,3]
C0583239
UMLS CUI [1,4]
C2348235
Reason for ICU admission unknown
Description

Reason for ICU admission unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0583239
UMLS CUI [1,3]
C0439673
Fraility and renal failure
Description

Fraility and renal failure

Clinical Frailty Score (CFS/9)
Description

Clinical Frailty Score (CFS/9)

Data type

integer

Alias
UMLS CUI [1]
C4706357
Clinical Frailty Score unknown
Description

Clinical Frailty Score (CFS/9) unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C4706357
UMLS CUI [1,2]
C0439673
Acute renal failure?
Description

Acute renal failure

Data type

integer

Alias
UMLS CUI [1]
C0022660
Complete daily for duration of ICU/ITU/IMC/HDU admission (between 00:00 to 24:00 on day of assessment):
Description

Complete daily for duration of ICU/ITU/IMC/HDU admission (between 00:00 to 24:00 on day of assessment):

Alias
UMLS CUI-1
C0332173
UMLS CUI-2
C0684224
IF patient is <18 years: PELOD Total Score
Description

All following items: record the ‘worst’ value on the day of assessment.

Data type

integer

Alias
UMLS CUI [1,1]
C1521725
UMLS CUI [1,2]
C3494458
UMLS CUI [1,3]
C2964552
IF patient is <18 years: PELOD Total Score unknown
Description

PELOD Total Score unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C1521725
UMLS CUI [1,2]
C3494458
UMLS CUI [1,3]
C2964552
UMLS CUI [1,4]
C0439673
If patient is <18 years: PRISM III score
Description

PRISM III score

Data type

integer

Alias
UMLS CUI [1,1]
C0475502
UMLS CUI [1,2]
C0449820
If patient is <18 years: PRISM III score unknown
Description

PRISM III score unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0475502
UMLS CUI [1,2]
C0449820
UMLS CUI [1,3]
C0439673
Fluid balance (in last 24 hours)
Description

Fluid balance

Data type

integer

Measurement units
  • ml
Alias
UMLS CUI [1,1]
C0016284
UMLS CUI [1,2]
C3897986
ml
Fluid balance (in last 24 hours) unknown
Description

Fluid balance unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0016284
UMLS CUI [1,2]
C3897986
UMLS CUI [1,3]
C0439673
Nutrition
Description

Nutrition

Data type

integer

Alias
UMLS CUI [1]
C2937349
Best physical mobility (see scoring in itemdescription)
Description

0 = Passively moved by staff (incl. passive cycling only) 1 = Any activity in bed, but not moving out of or over edge of bed (incl. cycling) 2 = Passively moved to chair (no standing or sitting at edge of bed) 3 = Actively sitting over side of bed with some trunk control (may be assisted) 4 = Standing 5 = Transferring from bed to chair 6 = Marching on the spot (at bedside; > 2steps/foot) 7 = Walking with assistance of 2 or more people (>5m) 8 = Walking with assistance of 1 person (>5m) 9 = Walking independently with gait aid (>5m) 10 = Walking independently without gait aid (>5m)

Data type

integer

Alias
UMLS CUI [1,1]
C1522427
UMLS CUI [1,2]
C0871081
UMLS CUI [1,3]
C0449820
Best physical mobility score unknown
Description

Best physical mobility score unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C1522427
UMLS CUI [1,2]
C0871081
UMLS CUI [1,3]
C0449820
UMLS CUI [1,4]
C0439673
Is the patient currently receiving (between 00:00 to 24:00 on day of assessment):
Description

Is the patient currently receiving (between 00:00 to 24:00 on day of assessment):

Alias
UMLS CUI-1
C2827774
Invasive ventilation?
Description

Invasive ventilation during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C1868981
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes: ETT
Description

Invasive ventilation during evaluation period: ETT

Data type

boolean

Alias
UMLS CUI [1,1]
C1868981
UMLS CUI [1,2]
C0442465
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes: Tracheostomy
Description

Invasive ventilation during evaluation period: Tracheostomy

Data type

boolean

Alias
UMLS CUI [1,1]
C0184159
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes: Other invasive ventilation
Description

Other invasive ventilation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C1868981
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If other invasive ventilation - please specify:
Description

Other invasive ventilation - specification

Data type

text

Alias
UMLS CUI [1,1]
C2348235
UMLS CUI [1,2]
C0205394
UMLS CUI [1,3]
C1868981
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
Type of invasive ventilation unknown
Description

Type of invasive ventilation during evaluation period unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0439673
UMLS CUI [1,2]
C0332307
UMLS CUI [1,3]
C1868981
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
Non-invasive ventilation?
Description

Non-invasive ventilation during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C1997883
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes: BIPAP
Description

Non-invasive ventilation during evaluation period: BIPAP

Data type

boolean

Alias
UMLS CUI [1,1]
C5214466
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes: CPAP
Description

Non-invasive ventilation during evaluation period: CPAP

Data type

boolean

Alias
UMLS CUI [1,1]
C3845201
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes: Other non-invasive ventilation
Description

Other non-invasive ventilation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C1997883
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
Other non-invasive ventilation - please specify:
Description

Other non-invasive ventilation during evaluation period - specification

Data type

text

Alias
UMLS CUI [1,1]
C2348235
UMLS CUI [1,2]
C0205394
UMLS CUI [1,3]
C1997883
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
Type of other non-invasive ventilation unknown
Description

Unknown type of non-invasive ventilation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0439673
UMLS CUI [1,2]
C0332307
UMLS CUI [1,3]
C1997883
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
Humidified high flow nasal cannula (HHFNC)?
Description

Humidified high flow nasal cannula during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C0582480
UMLS CUI [1,2]
C1960097
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If mechanically ventilated: Mode of ventilation (specify):
Description

Mode of mechanical ventilation during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C2223979
UMLS CUI [1,2]
C2348235
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If "Other" ticked - please specify:
Description

Other mode of mechanical ventilation - specification

Data type

text

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C2223979
UMLS CUI [1,3]
C2348235
Other mode of mechanical ventilation unknown
Description

Other mode of mechanical ventilation unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C2223979
UMLS CUI [1,3]
C2348235
UMLS CUI [1,4]
C0439673
Highest Tidal volume within last 24hrs:
Description

Mechanically ventilated: highest tidal volume past 24 hours

Data type

integer

Measurement units
  • ml/Kg of Ideal Body Weight
Alias
UMLS CUI [1,1]
C0199470
UMLS CUI [1,2]
C1522410
UMLS CUI [1,3]
C0040210
UMLS CUI [1,4]
C3897986
ml/Kg of Ideal Body Weight
Highest Tidal volume within last 24hrs unknown
Description

Mechanically ventilated: highest tidal volume past 24 hours unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0199470
UMLS CUI [1,2]
C1522410
UMLS CUI [1,3]
C0040210
UMLS CUI [1,4]
C3897986
UMLS CUI [1,5]
C0439673
Highest Positive end expiratory pressure within last 24hrs:
Description

Mechanically ventilated: Highest Positive end expiratory pressure within last 24hrs

Data type

integer

Measurement units
  • cmH2O
Alias
UMLS CUI [1,1]
C0199470
UMLS CUI [1,2]
C1522410
UMLS CUI [1,3]
C0032740
UMLS CUI [1,4]
C3897986
cmH2O
Highest Positive end expiratory pressure within last 24hrs unknown
Description

Mechanically ventilated: Highest Positive end expiratory pressure within last 24hrs unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0199470
UMLS CUI [1,2]
C1522410
UMLS CUI [1,3]
C0032740
UMLS CUI [1,4]
C3897986
UMLS CUI [1,5]
C0439673
Highest Airway plateau pressure within last 24 hrs
Description

Mechanically ventilated: Highest Airway plateau pressure within last 24 hrs

Data type

integer

Measurement units
  • cmH2O
Alias
UMLS CUI [1,1]
C0199470
UMLS CUI [1,2]
C1522410
UMLS CUI [1,3]
C3697386
UMLS CUI [1,4]
C3897986
cmH2O
Highest Airway plateau pressure within last 24 hrs unknown
Description

Mechanically ventilated: Highest Airway plateau pressure within last 24 hrs unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0199470
UMLS CUI [1,2]
C1522410
UMLS CUI [1,3]
C3697386
UMLS CUI [1,4]
C3897986
UMLS CUI [1,5]
C0439673
Prone positioning?
Description

Prone positioning during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C4551696
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes, total duration of hours spent in prone position:
Description

Total duration of prone positioning during evaluation period

Data type

integer

Measurement units
  • hours
Alias
UMLS CUI [1,1]
C0439810
UMLS CUI [1,2]
C2926735
UMLS CUI [1,3]
C4551696
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
hours
Total duration of hours spent in prone position unknown
Description

Total duration of prone positioning during evaluation period unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0439810
UMLS CUI [1,2]
C2926735
UMLS CUI [1,3]
C4551696
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
UMLS CUI [1,7]
C0439673
Sedation?
Description

Sedation during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C0344106
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes: Benzodiazepines
Description

Sedation via benzodiazepines during evaluation period during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0344106
UMLS CUI [1,2]
C4479798
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes: Propofol
Description

Sedation via propofol during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0344106
UMLS CUI [1,2]
C0033487
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes: Narcotics
Description

Sedation via narcotics during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0344106
UMLS CUI [1,2]
C0027415
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes: Other
Description

Other sedation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C0344106
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Other, please specify:
Description

Other sedation during evaluation period - specification

Data type

text

Alias
UMLS CUI [1,1]
C2348235
UMLS CUI [1,2]
C0205394
UMLS CUI [1,3]
C0344106
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
Unknown pharmaceutical preparation for sedation
Description

Unknown pharmaceutical preparation for sedation during evaluation period

Data type

text

Alias
UMLS CUI [1,1]
C0439673
UMLS CUI [1,2]
C0013227
UMLS CUI [1,3]
C0344106
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
Diuretic?
Description

Diuretic during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C0012798
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes, total duration:
Description

Diuretic during evaluation period

Data type

integer

Measurement units
  • hours
Alias
UMLS CUI [1,1]
C0439810
UMLS CUI [1,2]
C2926735
UMLS CUI [1,3]
C0012798
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
hours
Total duration unknown
Description

Total duration of diuretic during evaluation period unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0439810
UMLS CUI [1,2]
C2926735
UMLS CUI [1,3]
C0012798
UMLS CUI [1,4]
C0439673
UMLS CUI [1,5]
C0347984
UMLS CUI [1,6]
C0220825
UMLS CUI [1,7]
C1948053
Total daily dose of diuretic
Description

Total daily dose of diuretic during evaluation period

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C0439810
UMLS CUI [1,2]
C2348070
UMLS CUI [1,3]
C0012798
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
mg
Total daily dose of diuretic unknown
Description

Total daily dose of diuretic unknown

Data type

boolean

Alias
UMLS CUI [1,1]
C0439810
UMLS CUI [1,2]
C2348070
UMLS CUI [1,3]
C0012798
UMLS CUI [1,4]
C0439673
UMLS CUI [1,5]
C0347984
UMLS CUI [1,6]
C0220825
UMLS CUI [1,7]
C1948053
Dialysis/Hemofiltration?
Description

Dialysis/Hemofiltration during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C0019014
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
UMLS CUI [2,1]
C0011946
UMLS CUI [2,2]
C0347984
UMLS CUI [2,3]
C0220825
UMLS CUI [2,4]
C1948053
If Yes: CRRT
Description

CRRT during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C3649547
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes: IHD
Description

IHD during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0472676
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes: SLED
Description

SLED during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C3698381
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If Yes: Other
Description

Other dialysis procedure during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0205394
UMLS CUI [1,2]
C0011946
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
UMLS CUI [2,1]
C0205394
UMLS CUI [2,2]
C0019014
UMLS CUI [2,3]
C0347984
UMLS CUI [2,4]
C0220825
UMLS CUI [2,5]
C1948053
If Other, please specify:
Description

Other dialysis procedure during evaluation period - specification

Data type

text

Alias
UMLS CUI [1,1]
C2348235
UMLS CUI [1,2]
C0205394
UMLS CUI [1,3]
C0011946
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
UMLS CUI [2,1]
C2348235
UMLS CUI [2,2]
C0205394
UMLS CUI [2,3]
C0019014
UMLS CUI [2,4]
C0347984
UMLS CUI [2,5]
C0220825
UMLS CUI [2,6]
C1948053
Type of dialysis procedure or hemofiltration unknown
Description

Type of dialysis procedure or hemofiltration during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0011946
UMLS CUI [1,3]
C0439673
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
UMLS CUI [2,1]
C0332307
UMLS CUI [2,2]
C0019014
UMLS CUI [2,3]
C0439673
UMLS CUI [2,4]
C0347984
UMLS CUI [2,5]
C0220825
UMLS CUI [2,6]
C1948053
If CRRT, type of anti-coagulant: Heparin
Description

CRRT - anti-coagulation with heparin during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C3649547
UMLS CUI [1,2]
C0019134
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If CRRT, type of anti-coagulant: Citrate
Description

CRRT - anti-coagulation with citrate during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C3649547
UMLS CUI [1,2]
C3877358
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If CRRT, type of anti-coagulant: none
Description

CRRT - no anti-coagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C3649547
UMLS CUI [1,2]
C0741139
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
If CRRT, type of anti-coagulant: unknown
Description

CRRT - unknown anticoagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C3649547
UMLS CUI [1,2]
C0003281
UMLS CUI [1,3]
C0439673
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
Heparin for systemic anticoagulation ?
Description

Heparin for systemic anticoagulation during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C0003281
UMLS CUI [1,2]
C0019134
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes, Low-molecular weight
Description

Low-molecular weight heparin for systemic anticoagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0003281
UMLS CUI [1,2]
C0019139
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes, unfractionated
Description

Unfractionated heparin for systemic anticoagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0003281
UMLS CUI [1,2]
C2825026
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes, type of heparin unknown
Description

Unknown type heparin for systemic anticoagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0003281
UMLS CUI [1,2]
C0019134
UMLS CUI [1,3]
C0302898
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
If Yes, subcutaneous
Description

Subcutaneous administration route of heparin for systemic anticoagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0019134
UMLS CUI [1,2]
C1522438
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes, intravenous
Description

Intravenous administration route of heparin for systemic anticoagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0019134
UMLS CUI [1,2]
C1522726
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
Route of administration unknown
Description

Unknown administration route of heparin for systemic anticoagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0019134
UMLS CUI [1,2]
C1521803
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes, therapeutic
Description

Therapeutic drug level of heparin for systemic anticoagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C1168143
UMLS CUI [1,2]
C0019134
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes, Prophylactic
Description

Prophylactic drug level of heparin for systemic anticoagulation during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0420172
UMLS CUI [1,2]
C0019134
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
Drug level of heparin unknown
Description

Drug level of heparin for systemic anticoagulation unknown during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C3146298
UMLS CUI [1,2]
C0019134
UMLS CUI [1,3]
C0439673
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
Convalescent plasma?
Description

Convalescent plasma during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C0032105
UMLS CUI [1,2]
C0740326
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C0220825
UMLS CUI [1,5]
C1948053
If Yes, transfusion volume:
Description

Transfusion volume of convalescent plasma during evaluation period

Data type

integer

Measurement units
  • ml
Alias
UMLS CUI [1,1]
C0740326
UMLS CUI [1,2]
C0032105
UMLS CUI [1,3]
C0370078
UMLS CUI [1,4]
C0347984
UMLS CUI [1,5]
C0220825
UMLS CUI [1,6]
C1948053
ml
Transfusion volume unknown
Description

Transfusion volume of convalescent plasma unknown during evaluation period

Data type

boolean

Alias
UMLS CUI [1,1]
C0740326
UMLS CUI [1,2]
C0032105
UMLS CUI [1,3]
C0370078
UMLS CUI [1,4]
C0439673
UMLS CUI [1,5]
C0347984
UMLS CUI [1,6]
C0220825
UMLS CUI [1,7]
C1948053
Blood transfusion?
Description

Blood transfusion during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C0005841
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053
Platelet transfusion?
Description

Platelet transfusion during evaluation period

Data type

integer

Alias
UMLS CUI [1,1]
C0086818
UMLS CUI [1,2]
C0347984
UMLS CUI [1,3]
C0220825
UMLS CUI [1,4]
C1948053

Similar models

COVID-19 Case Report Form Rapid Critical Care Module - Part B

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Participant Identification Numbers
C3165543 (UMLS CUI-1)
Participant Identification Numbers
Item
Participant Identification Numbers
text
C3165543 (UMLS CUI [1])
Item Group
ICU/HDU Admission Form
C0583239 (UMLS CUI-1)
C1301858 (UMLS CUI-2)
ICU admission date
Item
ICU admission date (DD/MM/YYYY):
date
C0583239 (UMLS CUI [1,1])
C1302393 (UMLS CUI [1,2])
Item
Enrolment in interventional clinical study?
integer
C1516879 (UMLS CUI [1,1])
C3274035 (UMLS CUI [1,2])
Code List
Enrolment in interventional clinical study?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Enrolment in interventional clinical study - name of study
Item
If YES, name of study:
integer
C1516879 (UMLS CUI [1,1])
C3274035 (UMLS CUI [1,2])
C2348560 (UMLS CUI [1,3])
Treatment/s trialled
Item
Treatment/s trialled:
text
C0087111 (UMLS CUI [1,1])
C3274035 (UMLS CUI [1,2])
Name of study or trialled treatment unknown
Item
Name of study or trialled treatment unknown
boolean
C0087111 (UMLS CUI [1,1])
C3274035 (UMLS CUI [1,2])
C0439673 (UMLS CUI [1,3])
C3274035 (UMLS CUI [2,1])
C0439673 (UMLS CUI [2,2])
C2348560 (UMLS CUI [2,3])
Item Group
Reason for ICU admission (tick all that apply):
C0392360 (UMLS CUI-1)
C0583239 (UMLS CUI-2)
Reason for ICU admission: Respiratory failure
Item
Respiratory failure
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C1145670 (UMLS CUI [1,3])
Reason for ICU admission: Septic shock
Item
Septic shock
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C0036983 (UMLS CUI [1,3])
Reason for ICU admission: Venous thromboembolism
Item
Venous thromboembolism
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C1861172 (UMLS CUI [1,3])
Reason for ICU admission: Cardiovascular complications
Item
Cardiovascular complications
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C0007226 (UMLS CUI [1,3])
C0009566 (UMLS CUI [1,4])
Reason for ICU admission: Acute kidney injury
Item
Acute kidney injury
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C2609414 (UMLS CUI [1,3])
Reason for ICU admission: Acute liver injury
Item
Acute liver injury
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C2242583 (UMLS CUI [1,3])
Reason for ICU admission: Neurological complications
Item
Neurological complications
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C0235029 (UMLS CUI [1,3])
Reason for ICU admission: Secondary infection
Item
Secondary infection
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C0442886 (UMLS CUI [1,3])
Reason for ICU admission: Pancreatic injury
Item
Pancreatic injury
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C0010957 (UMLS CUI [1,3])
C0030274 (UMLS CUI [1,4])
Reason for ICU admission: Disseminated intravascular coagulation
Item
Disseminated intravascular coagulation
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C0012739 (UMLS CUI [1,3])
Reason for ICU admission: Pregnancy related complications
Item
Pregnancy related complications
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C0032962 (UMLS CUI [1,3])
Reason for ICU admission: Rhabdomyolysis
Item
Rhabdomyolysis
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C0035410 (UMLS CUI [1,3])
Other reason for ICU admission
Item
Other reason for ICU admission
boolean
C0205394 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
C0583239 (UMLS CUI [1,3])
Other reason for ICU admission - specification
Item
Other - please specify:
text
C0205394 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
C0583239 (UMLS CUI [1,3])
C2348235 (UMLS CUI [1,4])
Reason for ICU admission unknown
Item
Reason for ICU admission unknown
boolean
C0392360 (UMLS CUI [1,1])
C0583239 (UMLS CUI [1,2])
C0439673 (UMLS CUI [1,3])
Item Group
Fraility and renal failure
Clinical Frailty Score (CFS/9)
Item
Clinical Frailty Score (CFS/9)
integer
C4706357 (UMLS CUI [1])
Clinical Frailty Score (CFS/9) unknown
Item
Clinical Frailty Score unknown
boolean
C4706357 (UMLS CUI [1,1])
C0439673 (UMLS CUI [1,2])
Item
Acute renal failure?
integer
C0022660 (UMLS CUI [1])
Code List
Acute renal failure?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item Group
Complete daily for duration of ICU/ITU/IMC/HDU admission (between 00:00 to 24:00 on day of assessment):
C0332173 (UMLS CUI-1)
C0684224 (UMLS CUI-2)
PELOD Total Score
Item
IF patient is <18 years: PELOD Total Score
integer
C1521725 (UMLS CUI [1,1])
C3494458 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
PELOD Total Score unknown
Item
IF patient is <18 years: PELOD Total Score unknown
boolean
C1521725 (UMLS CUI [1,1])
C3494458 (UMLS CUI [1,2])
C2964552 (UMLS CUI [1,3])
C0439673 (UMLS CUI [1,4])
PRISM III score
Item
If patient is <18 years: PRISM III score
integer
C0475502 (UMLS CUI [1,1])
C0449820 (UMLS CUI [1,2])
PRISM III score unknown
Item
If patient is <18 years: PRISM III score unknown
boolean
C0475502 (UMLS CUI [1,1])
C0449820 (UMLS CUI [1,2])
C0439673 (UMLS CUI [1,3])
Fluid balance
Item
Fluid balance (in last 24 hours)
integer
C0016284 (UMLS CUI [1,1])
C3897986 (UMLS CUI [1,2])
Fluid balance unknown
Item
Fluid balance (in last 24 hours) unknown
boolean
C0016284 (UMLS CUI [1,1])
C3897986 (UMLS CUI [1,2])
C0439673 (UMLS CUI [1,3])
Item
Nutrition
integer
C2937349 (UMLS CUI [1])
Code List
Nutrition
CL Item
Parenteral (1)
CL Item
Enteral (2)
CL Item
NPO (3)
CL Item
Unknown (4)
Best physical mobility
Item
Best physical mobility (see scoring in itemdescription)
integer
C1522427 (UMLS CUI [1,1])
C0871081 (UMLS CUI [1,2])
C0449820 (UMLS CUI [1,3])
Best physical mobility score unknown
Item
Best physical mobility score unknown
boolean
C1522427 (UMLS CUI [1,1])
C0871081 (UMLS CUI [1,2])
C0449820 (UMLS CUI [1,3])
C0439673 (UMLS CUI [1,4])
Item Group
Is the patient currently receiving (between 00:00 to 24:00 on day of assessment):
C2827774 (UMLS CUI-1)
Item
Invasive ventilation?
integer
C1868981 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
Code List
Invasive ventilation?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Invasive ventilation during evaluation period: ETT
Item
If Yes: ETT
boolean
C1868981 (UMLS CUI [1,1])
C0442465 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Invasive ventilation during evaluation period: Tracheostomy
Item
If Yes: Tracheostomy
boolean
C0184159 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
Other invasive ventilation during evaluation period
Item
If Yes: Other invasive ventilation
boolean
C0205394 (UMLS CUI [1,1])
C1868981 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Other invasive ventilation - specification
Item
If other invasive ventilation - please specify:
text
C2348235 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C1868981 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Type of invasive ventilation during evaluation period unknown
Item
Type of invasive ventilation unknown
boolean
C0439673 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C1868981 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Item
Non-invasive ventilation?
integer
C1997883 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
Code List
Non-invasive ventilation?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Non-invasive ventilation during evaluation period: BIPAP
Item
If Yes: BIPAP
boolean
C5214466 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
Non-invasive ventilation during evaluation period: CPAP
Item
If Yes: CPAP
boolean
C3845201 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
Other non-invasive ventilation during evaluation period
Item
If Yes: Other non-invasive ventilation
boolean
C0205394 (UMLS CUI [1,1])
C1997883 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Other non-invasive ventilation during evaluation period - specification
Item
Other non-invasive ventilation - please specify:
text
C2348235 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C1997883 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Unknown type of non-invasive ventilation during evaluation period
Item
Type of other non-invasive ventilation unknown
boolean
C0439673 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C1997883 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Item
Humidified high flow nasal cannula (HHFNC)?
integer
C0582480 (UMLS CUI [1,1])
C1960097 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Code List
Humidified high flow nasal cannula (HHFNC)?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If mechanically ventilated: Mode of ventilation (specify):
integer
C2223979 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Code List
If mechanically ventilated: Mode of ventilation (specify):
CL Item
Volume controlled (VC) (1)
CL Item
Pressure controlled (PC) (2)
CL Item
Other (3)
CL Item
Unknown (4)
Other mode of mechanical ventilation - specification
Item
If "Other" ticked - please specify:
text
C0205394 (UMLS CUI [1,1])
C2223979 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Other mode of mechanical ventilation unknown
Item
Other mode of mechanical ventilation unknown
boolean
C0205394 (UMLS CUI [1,1])
C2223979 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
C0439673 (UMLS CUI [1,4])
Mechanically ventilated: highest tidal volume past 24 hours
Item
Highest Tidal volume within last 24hrs:
integer
C0199470 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
C0040210 (UMLS CUI [1,3])
C3897986 (UMLS CUI [1,4])
Mechanically ventilated: highest tidal volume past 24 hours unknown
Item
Highest Tidal volume within last 24hrs unknown
boolean
C0199470 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
C0040210 (UMLS CUI [1,3])
C3897986 (UMLS CUI [1,4])
C0439673 (UMLS CUI [1,5])
Mechanically ventilated: Highest Positive end expiratory pressure within last 24hrs
Item
Highest Positive end expiratory pressure within last 24hrs:
integer
C0199470 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
C0032740 (UMLS CUI [1,3])
C3897986 (UMLS CUI [1,4])
Mechanically ventilated: Highest Positive end expiratory pressure within last 24hrs unknown
Item
Highest Positive end expiratory pressure within last 24hrs unknown
boolean
C0199470 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
C0032740 (UMLS CUI [1,3])
C3897986 (UMLS CUI [1,4])
C0439673 (UMLS CUI [1,5])
Mechanically ventilated: Highest Airway plateau pressure within last 24 hrs
Item
Highest Airway plateau pressure within last 24 hrs
integer
C0199470 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
C3697386 (UMLS CUI [1,3])
C3897986 (UMLS CUI [1,4])
Mechanically ventilated: Highest Airway plateau pressure within last 24 hrs unknown
Item
Highest Airway plateau pressure within last 24 hrs unknown
boolean
C0199470 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
C3697386 (UMLS CUI [1,3])
C3897986 (UMLS CUI [1,4])
C0439673 (UMLS CUI [1,5])
Prone positioning during evaluation period
Item
Prone positioning?
boolean
C4551696 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
Total duration of prone positioning during evaluation period
Item
If Yes, total duration of hours spent in prone position:
integer
C0439810 (UMLS CUI [1,1])
C2926735 (UMLS CUI [1,2])
C4551696 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Total duration of prone positioning during evaluation period unknown
Item
Total duration of hours spent in prone position unknown
boolean
C0439810 (UMLS CUI [1,1])
C2926735 (UMLS CUI [1,2])
C4551696 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
C0439673 (UMLS CUI [1,7])
Item
Sedation?
integer
C0344106 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Sedation via benzodiazepines during evaluation period during evaluation period
Item
If Yes: Benzodiazepines
boolean
C0344106 (UMLS CUI [1,1])
C4479798 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Sedation via propofol during evaluation period
Item
If Yes: Propofol
boolean
C0344106 (UMLS CUI [1,1])
C0033487 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Sedation via narcotics during evaluation period
Item
If Yes: Narcotics
boolean
C0344106 (UMLS CUI [1,1])
C0027415 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Other sedation during evaluation period
Item
If Yes: Other
boolean
C0205394 (UMLS CUI [1,1])
C0344106 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Other sedation during evaluation period - specification
Item
If Other, please specify:
text
C2348235 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0344106 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Unknown pharmaceutical preparation for sedation during evaluation period
Item
Unknown pharmaceutical preparation for sedation
text
C0439673 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C0344106 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Item
Diuretic?
integer
C0012798 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Diuretic during evaluation period
Item
If Yes, total duration:
integer
C0439810 (UMLS CUI [1,1])
C2926735 (UMLS CUI [1,2])
C0012798 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Total duration of diuretic during evaluation period unknown
Item
Total duration unknown
boolean
C0439810 (UMLS CUI [1,1])
C2926735 (UMLS CUI [1,2])
C0012798 (UMLS CUI [1,3])
C0439673 (UMLS CUI [1,4])
C0347984 (UMLS CUI [1,5])
C0220825 (UMLS CUI [1,6])
C1948053 (UMLS CUI [1,7])
Total daily dose of diuretic during evaluation period
Item
Total daily dose of diuretic
float
C0439810 (UMLS CUI [1,1])
C2348070 (UMLS CUI [1,2])
C0012798 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Total daily dose of diuretic unknown
Item
Total daily dose of diuretic unknown
boolean
C0439810 (UMLS CUI [1,1])
C2348070 (UMLS CUI [1,2])
C0012798 (UMLS CUI [1,3])
C0439673 (UMLS CUI [1,4])
C0347984 (UMLS CUI [1,5])
C0220825 (UMLS CUI [1,6])
C1948053 (UMLS CUI [1,7])
Item
Dialysis/Hemofiltration?
integer
C0019014 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
C0011946 (UMLS CUI [2,1])
C0347984 (UMLS CUI [2,2])
C0220825 (UMLS CUI [2,3])
C1948053 (UMLS CUI [2,4])
Code List
Dialysis/Hemofiltration?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CRRT during evaluation period
Item
If Yes: CRRT
boolean
C3649547 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
IHD during evaluation period
Item
If Yes: IHD
boolean
C0472676 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
SLED during evaluation period
Item
If Yes: SLED
boolean
C3698381 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
Other dialysis procedure during evaluation period
Item
If Yes: Other
boolean
C0205394 (UMLS CUI [1,1])
C0011946 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
C0205394 (UMLS CUI [2,1])
C0019014 (UMLS CUI [2,2])
C0347984 (UMLS CUI [2,3])
C0220825 (UMLS CUI [2,4])
C1948053 (UMLS CUI [2,5])
Other dialysis procedure during evaluation period - specification
Item
If Other, please specify:
text
C2348235 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0011946 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
C2348235 (UMLS CUI [2,1])
C0205394 (UMLS CUI [2,2])
C0019014 (UMLS CUI [2,3])
C0347984 (UMLS CUI [2,4])
C0220825 (UMLS CUI [2,5])
C1948053 (UMLS CUI [2,6])
Type of dialysis procedure or hemofiltration during evaluation period
Item
Type of dialysis procedure or hemofiltration unknown
boolean
C0332307 (UMLS CUI [1,1])
C0011946 (UMLS CUI [1,2])
C0439673 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
C0332307 (UMLS CUI [2,1])
C0019014 (UMLS CUI [2,2])
C0439673 (UMLS CUI [2,3])
C0347984 (UMLS CUI [2,4])
C0220825 (UMLS CUI [2,5])
C1948053 (UMLS CUI [2,6])
CRRT - anti-coagulation with heparin during evaluation period
Item
If CRRT, type of anti-coagulant: Heparin
boolean
C3649547 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
CRRT - anti-coagulation with citrate during evaluation period
Item
If CRRT, type of anti-coagulant: Citrate
boolean
C3649547 (UMLS CUI [1,1])
C3877358 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
CRRT - no anti-coagulation during evaluation period
Item
If CRRT, type of anti-coagulant: none
boolean
C3649547 (UMLS CUI [1,1])
C0741139 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
CRRT - unknown anticoagulation during evaluation period
Item
If CRRT, type of anti-coagulant: unknown
boolean
C3649547 (UMLS CUI [1,1])
C0003281 (UMLS CUI [1,2])
C0439673 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Item
Heparin for systemic anticoagulation ?
integer
C0003281 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Code List
Heparin for systemic anticoagulation ?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Low-molecular weight heparin for systemic anticoagulation during evaluation period
Item
If Yes, Low-molecular weight
boolean
C0003281 (UMLS CUI [1,1])
C0019139 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Unfractionated heparin for systemic anticoagulation during evaluation period
Item
If Yes, unfractionated
boolean
C0003281 (UMLS CUI [1,1])
C2825026 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Unknown type heparin for systemic anticoagulation during evaluation period
Item
If Yes, type of heparin unknown
boolean
C0003281 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])
C0302898 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Subcutaneous administration route of heparin for systemic anticoagulation during evaluation period
Item
If Yes, subcutaneous
boolean
C0019134 (UMLS CUI [1,1])
C1522438 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Intravenous administration route of heparin for systemic anticoagulation during evaluation period
Item
If Yes, intravenous
boolean
C0019134 (UMLS CUI [1,1])
C1522726 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Unknown administration route of heparin for systemic anticoagulation during evaluation period
Item
Route of administration unknown
boolean
C0019134 (UMLS CUI [1,1])
C1521803 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Therapeutic drug level of heparin for systemic anticoagulation during evaluation period
Item
If Yes, therapeutic
boolean
C1168143 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Prophylactic drug level of heparin for systemic anticoagulation during evaluation period
Item
If Yes, Prophylactic
boolean
C0420172 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Drug level of heparin for systemic anticoagulation unknown during evaluation period
Item
Drug level of heparin unknown
boolean
C3146298 (UMLS CUI [1,1])
C0019134 (UMLS CUI [1,2])
C0439673 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Item
Convalescent plasma?
integer
C0032105 (UMLS CUI [1,1])
C0740326 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C0220825 (UMLS CUI [1,4])
C1948053 (UMLS CUI [1,5])
Code List
Convalescent plasma?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Transfusion volume of convalescent plasma during evaluation period
Item
If Yes, transfusion volume:
integer
C0740326 (UMLS CUI [1,1])
C0032105 (UMLS CUI [1,2])
C0370078 (UMLS CUI [1,3])
C0347984 (UMLS CUI [1,4])
C0220825 (UMLS CUI [1,5])
C1948053 (UMLS CUI [1,6])
Transfusion volume of convalescent plasma unknown during evaluation period
Item
Transfusion volume unknown
boolean
C0740326 (UMLS CUI [1,1])
C0032105 (UMLS CUI [1,2])
C0370078 (UMLS CUI [1,3])
C0439673 (UMLS CUI [1,4])
C0347984 (UMLS CUI [1,5])
C0220825 (UMLS CUI [1,6])
C1948053 (UMLS CUI [1,7])
Item
Blood transfusion?
integer
C0005841 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
Code List
Blood transfusion?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Platelet transfusion?
integer
C0086818 (UMLS CUI [1,1])
C0347984 (UMLS CUI [1,2])
C0220825 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
Code List
Platelet transfusion?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)

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