Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of ... more Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involvin...
Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based app... more Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidel...
Background In contrast to adults, the situation for pediatric trauma care from an international p... more Background In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021–03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis....
Background Investigating the context of trauma and acute care surgery, the article aims at unders... more Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context o...
Conditions requiring emergency surgery and trauma care are still common in emergency systems and ... more Conditions requiring emergency surgery and trauma care are still common in emergency systems and require immediate evaluation and timely resolution even during a pandemic as is currently happening with COVID-19, a scenario that threatens to affect their capacity to provide care5,8. In these cases, certain measures must be taken for the special care of health care workers and their patients, who are often admitted in critical condition and require an immediate surgical intervention that does not allow for any delay. For this purpose, an algorithm should be developed with recommendations which include a checklist to guide surgeons working in emergency and trauma systems about the issues to consider for the appropriate management and treatment of these conditions and for preparation of perioperative environments during the COVID-19 pandemic. The ultimate goal is to maintain adequate care with the necessary and required protection in each case5,8,11, raising awareness of the importance ...
Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care service... more Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results 367 collaborators from 59 countries responded to the survey....
Following the publication of the original article [1], the author name "Dragos Serban" under The ... more Following the publication of the original article [1], the author name "Dragos Serban" under The WSES COVID-19 emergency surgery survey collaboration group was incorrectly written as "Dragos Seban" instead of "Dragos Serban". The original article has been corrected.
El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagn... more El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagnosticas dificiles por sus sintomas no especificos, su evaluacion rutinaria de laboratorio y radiologica convencional poco utiles, que hacen del mismo un desafio clinico y terapeutico donde el drenaje quirurgico y la antibiotico-terapia especifica cumplen un rol fundamental. La presentacion de tres casos de nuestra casuistica permiten hacer la revision de la bibliografia y actualizadas consideraciones
El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagn... more El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagnosticas dificiles por sus sintomas no especificos, su evaluacion rutinaria de laboratorio y radiologica convencional poco utiles, que hacen del mismo un desafio clinico y terapeutico donde el drenaje quirurgico y la antibiotico-terapia especifica cumplen un rol fundamental. La presentacion de tres casos de nuestra casuistica permiten hacer la revision de la bibliografia y actualizadas consideraciones
El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagn... more El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagnosticas dificiles por sus sintomas no especificos, su evaluacion rutinaria de laboratorio y radiologica convencional poco utiles, que hacen del mismo un desafio clinico y terapeutico donde el drenaje quirurgico y la antibiotico-terapia especifica cumplen un rol fundamental. La presentacion de tres casos de nuestra casuistica permiten hacer la revision de la bibliografia y actualizadas consideraciones
El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagn... more El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagnosticas dificiles por sus sintomas no especificos, su evaluacion rutinaria de laboratorio y radiologica convencional poco utiles, que hacen del mismo un desafio clinico y terapeutico donde el drenaje quirurgico y la antibiotico-terapia especifica cumplen un rol fundamental. La presentacion de tres casos de nuestra casuistica permiten hacer la revision de la bibliografia y actualizadas consideraciones
Spontaneous pneumothorax is still the most frequent surgical thoracic disease in a general hospit... more Spontaneous pneumothorax is still the most frequent surgical thoracic disease in a general hospital. In this report we present our systematization and results obtained with the management of 15 consecutive patients treated in one year, from June 1 s t 2001 through May 31 s t 2002. Of the 15 patients, 14 were primary and 1 secondary. Six were operated on, two of them for air leak and four for second episode. No mortality was observed in this group of patients.
Spontaneous pneumothorax is still the most frequent surgical thoracic disease in a general hospit... more Spontaneous pneumothorax is still the most frequent surgical thoracic disease in a general hospital. In this report we present our systematization and results obtained with the management of 15 consecutive patients treated in one year, from June 1 s t 2001 through May 31 s t 2002. Of the 15 patients, 14 were primary and 1 secondary. Six were operated on, two of them for air leak and four for second episode. No mortality was observed in this group of patients.
Introduction Quality in medical care must be measured in order to be improved. Trauma management ... more Introduction Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate resu...
Introduction Quality in medical care must be measured in order to be improved. Trauma management ... more Introduction Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate resu...
Background Emergency surgery represents a unique context. Trauma teams are often multidisciplinar... more Background Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma’s causes or the patient’s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills...
Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of ... more Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involvin...
Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based app... more Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidel...
Background In contrast to adults, the situation for pediatric trauma care from an international p... more Background In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021–03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis....
Background Investigating the context of trauma and acute care surgery, the article aims at unders... more Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context o...
Conditions requiring emergency surgery and trauma care are still common in emergency systems and ... more Conditions requiring emergency surgery and trauma care are still common in emergency systems and require immediate evaluation and timely resolution even during a pandemic as is currently happening with COVID-19, a scenario that threatens to affect their capacity to provide care5,8. In these cases, certain measures must be taken for the special care of health care workers and their patients, who are often admitted in critical condition and require an immediate surgical intervention that does not allow for any delay. For this purpose, an algorithm should be developed with recommendations which include a checklist to guide surgeons working in emergency and trauma systems about the issues to consider for the appropriate management and treatment of these conditions and for preparation of perioperative environments during the COVID-19 pandemic. The ultimate goal is to maintain adequate care with the necessary and required protection in each case5,8,11, raising awareness of the importance ...
Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care service... more Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results 367 collaborators from 59 countries responded to the survey....
Following the publication of the original article [1], the author name "Dragos Serban" under The ... more Following the publication of the original article [1], the author name "Dragos Serban" under The WSES COVID-19 emergency surgery survey collaboration group was incorrectly written as "Dragos Seban" instead of "Dragos Serban". The original article has been corrected.
El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagn... more El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagnosticas dificiles por sus sintomas no especificos, su evaluacion rutinaria de laboratorio y radiologica convencional poco utiles, que hacen del mismo un desafio clinico y terapeutico donde el drenaje quirurgico y la antibiotico-terapia especifica cumplen un rol fundamental. La presentacion de tres casos de nuestra casuistica permiten hacer la revision de la bibliografia y actualizadas consideraciones
El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagn... more El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagnosticas dificiles por sus sintomas no especificos, su evaluacion rutinaria de laboratorio y radiologica convencional poco utiles, que hacen del mismo un desafio clinico y terapeutico donde el drenaje quirurgico y la antibiotico-terapia especifica cumplen un rol fundamental. La presentacion de tres casos de nuestra casuistica permiten hacer la revision de la bibliografia y actualizadas consideraciones
El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagn... more El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagnosticas dificiles por sus sintomas no especificos, su evaluacion rutinaria de laboratorio y radiologica convencional poco utiles, que hacen del mismo un desafio clinico y terapeutico donde el drenaje quirurgico y la antibiotico-terapia especifica cumplen un rol fundamental. La presentacion de tres casos de nuestra casuistica permiten hacer la revision de la bibliografia y actualizadas consideraciones
El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagn... more El Absceso del psoas (AP) es una infrecuente y servera entidad que presenta consideraciones diagnosticas dificiles por sus sintomas no especificos, su evaluacion rutinaria de laboratorio y radiologica convencional poco utiles, que hacen del mismo un desafio clinico y terapeutico donde el drenaje quirurgico y la antibiotico-terapia especifica cumplen un rol fundamental. La presentacion de tres casos de nuestra casuistica permiten hacer la revision de la bibliografia y actualizadas consideraciones
Spontaneous pneumothorax is still the most frequent surgical thoracic disease in a general hospit... more Spontaneous pneumothorax is still the most frequent surgical thoracic disease in a general hospital. In this report we present our systematization and results obtained with the management of 15 consecutive patients treated in one year, from June 1 s t 2001 through May 31 s t 2002. Of the 15 patients, 14 were primary and 1 secondary. Six were operated on, two of them for air leak and four for second episode. No mortality was observed in this group of patients.
Spontaneous pneumothorax is still the most frequent surgical thoracic disease in a general hospit... more Spontaneous pneumothorax is still the most frequent surgical thoracic disease in a general hospital. In this report we present our systematization and results obtained with the management of 15 consecutive patients treated in one year, from June 1 s t 2001 through May 31 s t 2002. Of the 15 patients, 14 were primary and 1 secondary. Six were operated on, two of them for air leak and four for second episode. No mortality was observed in this group of patients.
Introduction Quality in medical care must be measured in order to be improved. Trauma management ... more Introduction Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate resu...
Introduction Quality in medical care must be measured in order to be improved. Trauma management ... more Introduction Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate resu...
Background Emergency surgery represents a unique context. Trauma teams are often multidisciplinar... more Background Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma’s causes or the patient’s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills...
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