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Correa Bonito A, Cerdán Santacruz C, Pellino G, Fernández Miguel T, Bermejo Marcos E, Rodríguez Sánchez A, García Septiem J, Martín-Pérez E. Results of a national survey about the management of patients with acute uncomplicated diverticulitis. Cir Esp 2024; 102:202-208. [PMID: 38341091 DOI: 10.1016/j.cireng.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/19/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Management of patients diagnosed of acute uncomplicated diverticulitis has evolved lately and according to the latest guidelines, outpatient treatment and management without antibiotherapy may be used in selected patients. The aim of this study is to evaluate the adhesión among national centres to these and others recommendations related to this pathology. METHODS An online national survey, that has been broadcast by several applications, was performed. The results obtained were statistically analysed. RESULTS A total of 104 surgeons participated, representing 69 national hospitals. Of those, in 82.6% of the centres, outpatient management is performed for acute uncomplicated diverticulitis. 23.2% of the hospitals have a protocol stablished for treatment without antibiotherapy in selected patients. Centres that do not follow these protocols allege that the mean reasons are the logistic difficulties to set them up (49.3%) and the lack of current evidence for it (44.8%). Significative statistical differences have been found when comparing the establishment of such protocols between centres with advanced accredited units and those who are not, with higher rates of outpatient management and treatment without antibiotics in accredited units (p ≤ .05). CONCLUSIONS In spite that this a very common disease, there is a huge national heterogeneity in its treatment. This is why it would adviseable to unify diagnostic and treatment criteria by the collaboration of scientific societies and the simplification of the development of hospitalary protocols.
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Affiliation(s)
- Alba Correa Bonito
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain.
| | - Carlos Cerdán Santacruz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Gianluca Pellino
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | - Tamara Fernández Miguel
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Galdakao-Usansolo, Bilbao, Spain
| | - Elena Bermejo Marcos
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Ana Rodríguez Sánchez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Javier García Septiem
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Elena Martín-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain
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Pérez Zapata AI, Rodríguez Cuéllar E, de la Fuente Bartolomé M, Martín-Arriscado Arroba C, García Morales MT, Loinaz Segurola C, Giner Nogueras M, Tejido Sánchez Á, Ruiz López P, Ferrero Herrero E, Zarco Pleguezuelos A, Romero Simó M, Caballero Bouza A, Parés Martinez D, Julián Ibáñez JF, Balibrea del Castillo JM, Morales Sevillano X, Díaz-Zorita Aguilar B, Martín Román L, Gomez Ruiz M, Fernández Miguel T, Cagigas Fernandez C, Moreno Bargueiras A, Cano Valderrama O, Alonso Rivera D, Gutiérrez Samaniego M, Elia Guedea M, Córdoba Diaz E, Gracia Solanas JA, Bañuls Matoses A, Macero Á, Sánchez López JD, Vaquero Pérez MA, Rojo López JA, Lima Pinto F, Bra Insa E, Rodríguez Prieto I, Padilla Zegarra ED, Franco Chacon M, Memba Ikuga R, Jorba Martin R, Alcaide Matas F, Troncoso Pereira P, Soria Aledo V, Pérez Guarinos CV, Genzor Rios S, Dobón Rascón MÁ, Núñez Fernández S, Valerias Domínguez E, García García M, Zambrana Campos V, Rebasa Cladera P, Artés Caselles M, Cea Soriano M, Gambí Pisonero D, Jiménez de los Galanes S, Frutos Bernal MD, Delegido García A, Gómez Pérez B, Montero Zorrilla C, Cortés Climent J, Vallejo Bernad C, Bustamante Mosquera R, Blázquez M, Muriel López J, García Pérez JC, Ocaña Jiménez J, Paseiro Crespo G, Pardo Martínez C, García Nebreda M, Fernández Cebrián JM, Casanova Durán V, Ferrer Márquez M, Aguiló Lucía J. Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study. Patient Saf Surg 2022; 16:7. [PMID: 35135570 PMCID: PMC8822669 DOI: 10.1186/s13037-021-00316-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/19/2021] [Indexed: 11/11/2022] Open
Abstract
Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies.
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