Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

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. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study : a WSES observational study

BackgroundTiming and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted.MethodsThis worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018.ResultsA total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate >= 22 breaths/min, systolic blood pressure 4mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8.ConclusionsThe simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.Peer reviewe

Quantitative risk assessment and safety databases in Romanian coal mining: preliminary systematic approach

Risk management is becoming increasingly more complex. Risk assessment, approached quantitatively, requires a factual database to define the likelihood of adverse health effects of workplace-related injuries and exposures, and it attempts to balance scientific knowledge with concerns of staff, investigators and administration. Practical guidance should be provided for Romanian coal mining companies to make progress in risk assessment process. Guidance is given on how to effectively introduce quantitative risk assessment in mining industry, the main goal being to highlight that the most valuable resource remains experience gained by effectively performing the process. Analyzing how various parameters are described/used, the paper aims to establish the place and role of quantitative risk analysis mining. Possibilities of developing safety/reliability database in coal mining are investigated. The block diagram describing the conceptual structure of a database on failures, safety of equipment and workers in the mining industry was developed. Because mining relies heavily on complex technologies - permanent mining facilities and large mobile equipment and support services - often located in isolated and hostile environments, the implementation of quantitative risk analysis and the development of a realistic database could be considered as a resilience business strategy and conversion of available knowledge into management actions

Methodology for Assessing the Degree of Occupational Safety Specific to Hydrotechnical Construction Activities, in Order to Increase Their Sustainability

The effectiveness of the audit is conditioned by the systematic nature of the analyses and their periodicity. In this respect, the work of internal auditors must be coherent, continuous, and professional. These conditions can be met only if the activity is organized as a permanent system, which has its objectives and has resources (human, material, and financial), as well as adequate tools (audit method) corresponding to the activities carried out within the hydro-construction companies. The methodology for assessing the occupational safety status specific to companies in the field of hydrotechnical constructions was tested at the economic operators within SC HIDROCONSTRUCȚIA SA Bucharest. Thus, from the observation made based on the two calculation formulas’ application, it can be appreciated that the weighted amount more clearly and objectively reflects the existence of problems in achieving safety and health at work, thus constituting the result of a cautious approach, as opposed to the arithmetic mean formula, which leads to a result that tends to overestimate the value of the assessment. Additionally, the security risk determination in the field of occupational security at the economic operators was performed, according to the procedure of applying the method, based on the Gumbel probability function associated with insecurity, and the accuracy of various estimates on risk predictors was ensured by using the Kolmogorov–Smirnov statistical verification test in order to determine the confidence interval of the forecast results

The generalized risk scale – a scalar integrated tool for developing risk criteria by consensus, in the field of explosives for civil uses

The paper highlights the result of the critical analysis upon criteria regarding the safety of explosives based on the quantification of risks specific for handling explosive materials, for the proper criteria selection and for defining the integrated concept “how safe is safe enough?”, applicable to complex work systems whose activity object involves the use of hazardous substances such as explosives for civil use. In this regard are conceptual and applicative presented judicial precedents and standards which are used for establishing risk acceptance criteria. These data and information are represented graphically along a series of logarithmic scales which ensure an objective manner for risk quantification based on scientific reasoning, real information derived from a data base which is specific for a deep knowledge of morbidity indicators recorded over an a statistically acceptable

The generalized risk scale – a scalar integrated tool for developing risk criteria by consensus, in the field of explosives for civil uses

The paper highlights the result of the critical analysis upon criteria regarding the safety of explosives based on the quantification of risks specific for handling explosive materials, for the proper criteria selection and for defining the integrated concept “how safe is safe enough?”, applicable to complex work systems whose activity object involves the use of hazardous substances such as explosives for civil use. In this regard are conceptual and applicative presented judicial precedents and standards which are used for establishing risk acceptance criteria. These data and information are represented graphically along a series of logarithmic scales which ensure an objective manner for risk quantification based on scientific reasoning, real information derived from a data base which is specific for a deep knowledge of morbidity indicators recorded over an a statistically acceptable

Safety culture: a perpetual challenge or an opportunity for Romanian companies?

The main objective of the paper is to analyze the safety culture in order to understand how theory and practice can be integrated to improve safety performance and related economic outcomes. The research includes the synthesis of systematic studies on safety culture and the factors that influence the relationship between organizational culture and safety behavior. In a global manner, the results obtained generate relevant insights into how safety culture can be theoretically systematized and provide a series of recommendations that can guide the development of future safety culture interventions. Finally, a framework is proposed for an in-depth understanding of all the implications of safety culture in the practice of Romanian companies

Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

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. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years