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Introduction <p>Considerable heterogeneity exists in the configuration and implementation maturity of trauma systems across European healthcare settings, and the opportunities for guideline-informed high-quality care varies considerably. Therefore, the European Society of Trauma and Emergency Surgery (ESTES), with its constituent national societies, has developed comprehensive consensus recommendations for care-context appropriate treatment of polytrauma patients in Europe, from the pre-hospital setting to the first surgical phase.</p> Methods <p>Adhering to the RAND/UCLA Appropriateness Method (RAM), ESTES conducted a three-round modified Delphi consensus. National society expert delegates assessed Grade of Recommendation (GoR) A and Good Clinical Practice Points (GPP) elements of the German Society of Trauma Surgery (DGU) “<i>S3 guidelines for polytrauma/severe injury management”</i> for appropriateness and implementability within their respective healthcare systems.</p> Results <p>In the first consensus round, 82 GoR A and 57 GPP recommendations were analysed. Of these, seven GPP were rephrased for clarity and four were removed due to redundancy or conflicting content. Consequently, 135 recommendations (82 GoR A and 53 GPP) remained, with 128 (77 GoR A and 51 GPP) deemed appropriate and necessary, and seven as uncertain due to expert disagreement.</p> Conclusion <p>These ESTES recommendations constitute the first cohesive Europe-wide framework for managing the polytrauma patient from the prehospital setting to the end of the first surgical phase. They serve as a foundational tool for the development of national guidelines, particularly in regions with evolving trauma systems, and promote alignment towards a uniform standard-of-care across Europe.</p>

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ESTES recommendations for the treatment of polytrauma—a European consensus based on the German S3 guidelines for the treatment of patients with severe/multiple injuries

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  • 发表日期：

    2025年4月11日

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  • Cristina Rey Valcarcel,
  • Dan Bieler,
  • Gary A. Bass,
  • Christine Gaarder,
  • Frank Hildebrand,
  • Ana María González,
  • Klemens Horst,
  • Enrico Marrano,
  • Christoph Nau,
  • Roman Pfeifer,
  • Agron Dogjani,
  • Michiel Herteleer,
  • Femke De Haes,
  • Vincent Duibusson,
  • Gerhard Achatz,
  • Diego Mariani,
  • Henrique Alexandrino,
  • Jorge Pereira,
  • Luís Vale,
  • Liliana Duarte,
  • Luís Ferreira,
  • Filipa Taré,
  • Filipa Madeira,
  • Maria João Koch,
  • Rui Escaleira,
  • Sérgio Baptista,
  • Marin Valeriu Surlin,
  • Krstina Doklestic Vasiljev,
  • Zlatibor Lončar,
  • Dušan Micić,
  • Vladimir Resanović,
  • Marija Milenković,
  • Lukas Rasulić,
  • Slađana Matić,
  • Dejan Stevanović,
  • Matevz Tomazevic,
  • Christian Michetitsch

摘要

Introduction

Considerable heterogeneity exists in the configuration and implementation maturity of trauma systems across European healthcare settings, and the opportunities for guideline-informed high-quality care varies considerably. Therefore, the European Society of Trauma and Emergency Surgery (ESTES), with its constituent national societies, has developed comprehensive consensus recommendations for care-context appropriate treatment of polytrauma patients in Europe, from the pre-hospital setting to the first surgical phase.

Methods

Adhering to the RAND/UCLA Appropriateness Method (RAM), ESTES conducted a three-round modified Delphi consensus. National society expert delegates assessed Grade of Recommendation (GoR) A and Good Clinical Practice Points (GPP) elements of the German Society of Trauma Surgery (DGU) “S3 guidelines for polytrauma/severe injury management” for appropriateness and implementability within their respective healthcare systems.

Results

In the first consensus round, 82 GoR A and 57 GPP recommendations were analysed. Of these, seven GPP were rephrased for clarity and four were removed due to redundancy or conflicting content. Consequently, 135 recommendations (82 GoR A and 53 GPP) remained, with 128 (77 GoR A and 51 GPP) deemed appropriate and necessary, and seven as uncertain due to expert disagreement.

Conclusion

These ESTES recommendations constitute the first cohesive Europe-wide framework for managing the polytrauma patient from the prehospital setting to the end of the first surgical phase. They serve as a foundational tool for the development of national guidelines, particularly in regions with evolving trauma systems, and promote alignment towards a uniform standard-of-care across Europe.