Resultados del Registro Nacional de Politraumatismos español ¿Dónde estamos y a dónde nos dirigimos? / Results of the Spanish National Polytrauma Registry. Where are we and where are we heading?

Introducción: En 2017 se emprendió el Registro Nacional de Politraumatismos (RNP) a nivel estatal español, cuya finalidad residía en mejorar la calidad de la atención al paciente politraumatizado grave y evaluar el uso de recursos y estrategias de tratamiento. El objetivo de este trabajo es presentar los datos recogidos en el RNP hasta la actualidad. Métodos: Estudio observacional retrospectivo a partir de los datos recogidos prospectivamente en el RNP. Se incluyen pacientes mayores de 14 años, con ISS≥15 o mecanismo de trauma penetrante, atendidos en 17 hospitales de tercer nivel de España. Resultados: Del 1/1/17 al 1/1/22 se han registrado un total de 2.069 pacientes politraumatizados. El 76,4% son varones; edad media: 45 años; ISS medio: 22,8 y mortalidad: 10,2%. El mecanismo de lesión más frecuente es el cerrado (80%) con mayor incidencia de accidentes de moto (23%). Un 12% de los pacientes sufren un traumatismo penetrante, por arma blanca en el 84%. Un 16% de los pacientes ingresa hemodinámicamente inestable en el hospital. Activando el protocolo de transfusión masiva en el 14% de los pacientes e interviniendo quirúrgicamente a un 53%. La estancia hospitalaria mediana es de 11 días. Precisando ingreso en la UCI un 73,4% (estancia media: 5 días). Conclusiones: Los pacientes politraumatizados registrados en el RNP son mayoritariamente varones de mediana edad, que sufren traumatismos cerrados y presentan una elevada incidencia de lesiones torácicas. La detección y el tratamiento dirigido de este tipo de lesiones probablemente permitirá mejorar la calidad asistencial del politraumatizado en nuestro medio. (AU)

Introduction: In 2017 the Spanish National Polytrauma Registry (SNPR) was initiated in Spain, its goal was to improve the quality of severe trauma management and evaluate the use of resources and treatment strategies. The objective of this study is to present the information obtained with the SNPR since it was initiated. Methods: Observational study with prospective data collection from the SNPR. Trauma patients included are older than 14 yeas, with ISS ≥ 15 or penetrating mechanism. In total 17 hospitals from Spain have participated. Results: From 1/1/17 to 1/1/22, 2069 trauma patients were registered. The majority were men (76.4%); mean age: 45 years; mean ISS: 22.8 and mortality: 10.2%. The most common mechanism of injury was blunt trauma (80%), being motorbike accident the most frequent (23%). Penetrating trauma is presented in 12% of patients, being stab wound the most common (84%). Sixteen percent of patients are hemodynamically unstable on hospital arrival. Massive transfusion protocol is activated in 14% of patients and 53% are operated. Median hospital stay is 11 days. There is a 73.4% of patients who need intensive care unit (ICU) admission, with a median ICU stay of 5 days. Conclusions: Trauma patients registered in the SNPR are predominantly middle-aged males who experience blunt trauma with a high incidence of thoracic injuries. Early and addressed detection of these kind of injuries would probably improve trauma quality of care in our environment. (AU)

Results of the Spanish National Polytrauma Registry. Where are we and where are we heading?

INTRODUCTION: In 2017, the Spanish National Polytrauma Registry (SNPR) was initiated in Spain with the goal to improve the quality of severe trauma management and evaluate the use of resources and treatment strategies. The objective of this study is to present the data obtained with the SNPR since its inception. METHODS: We conducted an observational study with prospective data collection from the SNPR. The trauma patients included were over 14 years of age, with ISS ≥ 15 or penetrating mechanism of injury, from a total of 17 tertiary hospitals in Spain. RESULTS: From 1/1/17 to 1/1/22, 2069 trauma patients were registered. The majority were men (76.4%), with a mean age of 45 years, mean ISS 22.8, and mortality 10.2%. The most common mechanism of injury was blunt trauma (80%), the most frequent being motorcycle accident (23%). Penetrating trauma was presented in 12% of patients, stab wounds being the most common (84%). On hospital arrival, 16% of patients were hemodynamically unstable. The massive transfusion protocol was activated in 14% of patients, and 53% underwent surgery. Median hospital stay was 11 days, while 73.4% of patients required intensive care unit (ICU) admission, with a median ICU stay of 5 days. CONCLUSIONS: Trauma patients registered in the SNPR are predominantly middle-aged males who experience blunt trauma with a high incidence of thoracic injuries. Early addressed detection and treatment of these kind of injuries would probably improve the quality of trauma care in our environment.

Analysis of the broadcasting and perceived utility through the implementation of a virtual training platform during the pandemic.

INTRODUCTION: The SARS-CoV-2 pandemic has affected training opportunities for healthcare professionals partly because face to face courses were cancelled. This study analyzes the results of participation and satisfaction of the AEC Virtual Classroom sessions during the first year. METHODS: The AEC Virtual Classroom includes a combined format of weekly Webinar broadcast live that can be viewed on a delayed basis in a virtual platform. In this study, the results in its first year are evaluated considering the number of live participants, the delayed views and the global reach; as well as the results of the satisfaction survey in each of the sessions (0-10). RESULTS: From 16/04/2020 to 15/04/2021, 50 sessions of the Virtual Classroom AEC were held. The average scope of the sessions was 509 ± 288 views with a range between 196 and 149. At the times of highest incidence of cases during the pandemic, a decrease in live participants was observed 275 ± 135 vs. 391 ± 233 (P = 0.032). The mean score on the format was 8.46 ± 0.31/10. The best-scored sessions were those of the subject related to coloproctology with a statistically significant difference in the mean score 8.79 ± 0.42 vs. 8.39 ± 0.27 (P = 0.035). 90% of users considered the sessions useful. 97.2% of respondents believe that the sessions should be maintained after the pandemic. CONCLUSIONS: The AEC Virtual Classroom has had very good results in the first year, proving to be a useful surgical teaching tool that will foreseeably survive once the pandemic is over.

[Analysis of the broadcasting and perceived utility through the implementation of a virtual training platform during the pandemic]. / Análisis de la difusión y utilidad percibida a través de la implementación de una plataforma de formación virtual durante la pandemia por COVID-19.

Introduction: The SARS-CoV-2 pandemic has affected training opportunities for healthcare professionals partly because face to face courses were cancelled. This study analyzes the results of participation and satisfaction of the AEC Virtual Classroom sessions during the first year. Methods: The AEC Virtual Classroom includes a combined format of weekly Webinar broadcast live that can be viewed on a delayed basis in a virtual platform. In this study, the results in its first year are evaluated considering the number of live participants, the delayed views and the global reach; as well as the results of the satisfaction survey in each of the sessions (0-10). Results: From 16/04/2020 to 15/04/2021, 50 sessions of the Virtual Classroom AEC were held. The average scope of the sessions was 509 ± 288 views with a range between 196 and 149. At the times of highest incidence of cases during the pandemic, a decrease in live participants was observed 275 ± 135 vs. 391 ± 233 (p = 0.032). The mean score on the format was 8.46 ± 0.31/10. The best-scored sessions were those of the subject related to coloproctology with a statistically significant difference in the mean score 8.79 ± 0.42 vs. 8.39 ± 0.27 (p = 0.035). 90% of users considered the sessions useful. 97.2% of respondents believe that the sessions should be maintained after the pandemic. Conclusions: The AEC Virtual Classroom has a very good results in the first year, proving to be a useful surgical teaching tool that will foreseeably survive once the pandemic is over.

Recommendations on intervention for hepatobiliary oncological surgery during the COVID-19 pandemic. / Recomendaciones de actuación en cirugía oncológica hepatobiliopancreática durante la pandemia COVID-19.

The SARS-CoV-2 (COVID-19) pandemic requires an analysis in the field of oncological surgery, both on the risk of infection, with very relevant clinical consequences, and on the need to generate plans to minimize the impact on possible restrictions on health resources. The AEC is making a proposal for the management of patients with hepatopancreatobiliary (HPB) malignancies in the different pandemic scenarios in order to offer the maximum benefit to patients, minimising the risks of COVID-19 infection, and optimising the healthcare resources available at any time. This requires the coordination of the different treatment options between the departments involved in the management of these patients: medical oncology, radiotherapy oncology, surgery, anaesthesia, radiology, endoscopy department and intensive care. The goal is offer effective treatments, adapted to the available resources, without compromising patients and healthcare professionals safety.

Manejo quirúrgico de pacientes con infección por COVID-19. Recomendaciones de la Asociación Española de Cirujanos / Surgical Management of Patients With COVID-19 Infection. Recommendations of the Spanish Association of Surgeons

Debido a la actual pandemia de enfermedad respiratoria denominada enfermedad por coronavirus 2019 (COVID-19) causada por el virus denominado SARS-CoV-2, numerosos pacientes con confirmación o sospecha de COVID-19 precisarán tratamiento quirúrgico electivo inaplazable o urgente. Estas situaciones requieren la adopción de medidas especiales da cara a minimizar la posibilidad de contagio entre pacientes, la exposición del personal sanitario y el desarrollo de complicaciones postoperatorias. En el presente documento se explican las principales medidas a tener en cuenta en caso de atención a pacientes COVID-19 o sospecha tanto durante su evaluación como en caso de requerir tratamiento quirúrgico

Due to the current pandemic of respiratory disease known as coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus, many patients with confirmed or suspected COVID-19 infection will require elective surgery, surgery that cannot be postponed, or emergency surgical treatment. In these situations, special measures need to be adopted in order to minimize the possibility of transmission between patients, exposure of healthcare personnel and the development of postoperative complications. This document explains the main principles to consider when managing confirmed or suspected COVID-19 patients during evaluation as well as when surgical treatment is required

Surgical Management of Patients With COVID-19 Infection. Recommendations of the Spanish Association of Surgeons. / Manejo quirúrgico de pacientes con infección por COVID-19. Recomendaciones de la Asociación Española de Cirujanos.

Due to the current pandemic of respiratory disease known as coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus, many patients with confirmed or suspected COVID-19 infection will require elective surgery, surgery that cannot be postponed, or emergency surgical treatment. In these situations, special measures need to be adopted in order to minimize the possibility of transmission between patients, exposure of healthcare personnel and the development of postoperative complications. This document explains the main principles to consider when managing confirmed or suspected COVID-19 patients during evaluation as well as when surgical treatment is required.

El modelo Acute Care Surgery en el mundo y la necesidad e implantación de unidades de trauma y cirugía de urgencia en España / The Acute Care Surgery model in the world, and the need for and implementation of trauma and emergency surgery units in Spain

El modelo Acute Care Surgery agrupa bajo una misma disciplina el trauma, la cirugía de urgencias y los cuidados intensivos posquirúrgicos. Concebido y extendido durante las 2 últimas décadas por territorio norteamericano, la magnitud e idiosincrasia clínica de la urgencia quirúrgica han hecho que este modelo se haya asumido en muchos otros puntos de la geografía mundial. En nuestro país, el reflejo ha sido la creación e implantación de las denominadas unidades de trauma y cirugía de urgencias, cuyos objetivos son comunes a las publicadas para el modelo original: evitar la nocturnidad en las urgencias quirúrgicas, liberar a los profesionales vinculados a la cirugía electiva en horario laboral y convertirse en el eslabón y referente perfectos de la continuidad asistencial. En el presente artículo se resumen el nacimiento y la expansión del modelo original, la evidencia aportada en cuanto a resultados y la situación actual en nuestro país

The Acute Care Surgery model groups trauma and emergency surgery with surgical critical care. Conceived and extended during the last 2 decades throughout North America, the magnitude and clinical idiosyncrasy of emergency general surgery have determined that this model has been expanded to other parts of the world. In our country, this has led to the introduction and implementation of the so-called trauma and emergency surgery units, with common objectives as those previously published for the original model: to decrease the rates of emergency surgery at night, to allow surgeons linked to elective surgery to develop their activity in their own disciplines during the daily schedule, and to become the perfect link and reference for the continuity of care. This review summarizes how the original model was born and how it expanded throughout the world, providing evidence in terms of results and a description of the current situation in our country

The Acute Care Surgery model in the world, and the need for and implementation of trauma and emergency surgery units in Spain. / El modelo Acute Care Surgery en el mundo y la necesidad e implantación de unidades de trauma y cirugía de urgencia en España.

The Acute Care Surgery model groups trauma and emergency surgery with surgical critical care. Conceived and extended during the last 2 decades throughout North America, the magnitude and clinical idiosyncrasy of emergency general surgery have determined that this model has been expanded to other parts of the world. In our country, this has led to the introduction and implementation of the so-called trauma and emergency surgery units, with common objectives as those previously published for the original model: to decrease the rates of emergency surgery at night, to allow surgeons linked to elective surgery to develop their activity in their own disciplines during the daily schedule, and to become the perfect link and reference for the continuity of care. This review summarizes how the original model was born and how it expanded throughout the world, providing evidence in terms of results and a description of the current situation in our country.