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Article ; Online: Prophylactic Negative-Pressure Wound Therapy After Laparotomy: Ongoing Discussion Following High-Quality Systematic Review.

Älgå, Andreas / Malmstedt, Jonas

2023 Volume 47, Issue 6, Page(s) 1475–1476

MeSH term(s)	Humans ; Negative-Pressure Wound Therapy ; Laparotomy/adverse effects ; Surgical Wound Infection/prevention & control ; Surgical Wound Dehiscence/prevention & control ; Longitudinal Studies
Language	English
Publishing date	2023-02-25
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-023-06948-z
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Article ; Online: Experiences of Acute Surgical Care During the Coronavirus Disease 2019 Pandemic Among Patients and Their Next of Kin.

Torbjörnsson, Eva / Fagerdahl, Ann-Mari / Älgå, Andreas

The Journal of surgical research

2022 Volume 277, Page(s) 163–170

Abstract: Introduction: Since March 2020, the coronavirus disease 2019 pandemic has affected healthcare systems worldwide. It is largely unknown how acutely ill surgical patients and their next of kin have perceived the hospital care during the ongoing pandemic. ... ...

Abstract	Introduction: Since March 2020, the coronavirus disease 2019 pandemic has affected healthcare systems worldwide. It is largely unknown how acutely ill surgical patients and their next of kin have perceived the hospital care during the ongoing pandemic. Therefore, we aimed to explore their experiences. Material and methods: We performed 12 interviews with patients who had undergone acute abdominal surgery in a public acute care hospital in Sweden during March to June 2020. In addition, we interviewed 10 of the patients' next of kin. We analyzed the interviews using content analysis. Results: Our analysis resulted in two themes: "Worries about seeking acute care" and "The surgical care worked adequately, even though the system was overloaded." The participants experienced that the hospital maintained its functionality during the ongoing pandemic. Both the patients and their next of kin experienced insufficient information by the hospital, especially during the initial acute phase and at discharge, which led to a perceived loss of control. The implemented ban on visitors was found to have had both positive and negative effects for the patients, whereas the next of kin's experiences focused on the difficulties with not being able to visit. Conclusions: Our findings indicate that the challenges of communication with patients and their next of kin are exacerbated during a crisis such as a pandemic. In addition, a ban on visitors might have both positive and negative aspects. Therefore, we propose individualized routines for visits to acute surgical patients when possible.
MeSH term(s)	COVID-19 ; Family ; Hospitals ; Humans ; Longitudinal Studies ; Pandemics ; Patient Discharge ; Qualitative Research
Language	English
Publishing date	2022-04-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.04.014
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Article ; Online: Wound specific quality of life after blast or gunshot injury: Validation of the wound QoL instrument.

Älgå, Andreas / Malmstedt, Jonas / Fagerdahl, Ann-Mari

PloS one

2022 Volume 17, Issue 10, Page(s) e0277094

Abstract: Background: Acute blast or gunshot wounds have a negative effect on the patients' health related quality of life (HRQoL). No validated instrument exists to assess the HRQoL of patients with such wounds. Therefore, we aimed to test and validate a ... ...

Abstract	Background: Acute blast or gunshot wounds have a negative effect on the patients' health related quality of life (HRQoL). No validated instrument exists to assess the HRQoL of patients with such wounds. Therefore, we aimed to test and validate a subscale of an existing HRQoL instrument among patients with acute blast or gunshot wounds. Methods: We used data from a randomized controlled trial comparing negative pressure wound therapy with standard treatment of civilian adults with acute extremity blast or gunshot wounds. We evaluated the reliability (internal consistency, stability) and validity of the body subscale of the Wound QoL instrument using the World Health Organisation 20 question self-reporting questionnaire as gold standard. Results: A total of 152 participants were included in the study. The participants were predominantly (93.4%) male, and median age was 29.0 years (IQR 21.0-34.0). The internal consistency was acceptable while a test-retest analysis indicated instability in the Wound QoL instrument. The content validity of the instrument was considered satisfactory; however, the criterion validity was found to be insufficient. Conclusions: Our results indicate that Wound QoL is a promising instrument for the assessment of wound specific HRQoL among patients with acute blast or gunshot wounds. Further testing and validation is needed.
MeSH term(s)	Adult ; Humans ; Male ; Female ; Quality of Life ; Reproducibility of Results ; Wounds, Gunshot ; Surveys and Questionnaires ; Self Report ; Psychometrics/methods
Language	English
Publishing date	2022-10-31
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0277094
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Article ; Online: Autotransfusion in low-resource settings: a scoping review.

Palmqvist, Maria / Von Schreeb, Johan / Älgå, Andreas

BMJ open

2022 Volume 12, Issue 5, Page(s) e056018

Abstract: Introduction: Globally, haemorrhage is the leading cause of both maternal mortality and preventable trauma death. For patients suffering from haemorrhage, prompt blood transfusion can be life-saving; however, safe and sufficient blood is often lacking ... ...

Abstract	Introduction: Globally, haemorrhage is the leading cause of both maternal mortality and preventable trauma death. For patients suffering from haemorrhage, prompt blood transfusion can be life-saving; however, safe and sufficient blood is often lacking in low-resource settings (LRS). Autotransfusion (AT), in which the patient's own blood is collected and transfused back, is an established alternative to donor blood transfusions, although one that is primarily performed with advanced AT systems. Research on basic AT in LRS is scarce. Therefore, we aimed to consolidate all available information on the current use of basic AT in LRS and to identify AT techniques and devices described for use in such settings. Design: Scoping review. Methods: We systematically searched four key databases: PubMed, Web of Science, Global Health and Cochrane Library as well as several grey literature databases and databases of relevant organisations. The final search was conducted on 22 April 2019. We included all types of studies referring to any information on basic AT used or sought to be used in LRS, published in English and dated after 31 December 2008. We synthesised the data from the included studies, results were charted or summarised narratively. Results: Some 370 records were reviewed, yielding 38 included documents. We found a paucity of scientific evidence as well as contradictory information on the extent of AT use and that AT use is largely undocumented. The most commonly described indications were haemoperitoneum (primarily among obstetric patients) and haemothorax. We identified three AT techniques used in LRS. Additionally, two new devices and one filter are described for potential use in LRS. Conclusions: Basic AT is practiced for certain obstetric and trauma indications. However, context-specific studies are needed to determine the technique's safety and effectiveness. Extent of use is difficult to assess, but our results indicate that basic AT is not a widely established practice in LRS. Future research should address the bottlenecks hampering basic AT availability. New AT devices for use in LRS are described, but their utility and cost-effectiveness remain to be assessed.
MeSH term(s)	Blood Transfusion, Autologous ; Cost-Benefit Analysis ; Female ; Hemorrhage ; Humans ; Pregnancy
Language	English
Publishing date	2022-05-16
Publishing country	England
Document type	Journal Article ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-056018
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Article ; Online: The development of preprints during the COVID-19 pandemic.

Älgå, Andreas / Eriksson, Oskar / Nordberg, Martin

Journal of internal medicine

2021 Volume 290, Issue 2, Page(s) 480–483

MeSH term(s)	COVID-19 ; Databases as Topic ; Humans ; Journal Impact Factor ; Machine Learning ; Pandemics ; Preprints as Topic/statistics & numerical data ; Publishing/trends
Language	English
Publishing date	2021-02-09
Publishing country	England
Document type	Editorial
ZDB-ID	96274-0
ISSN	1365-2796 ; 0954-6820
ISSN (online)	1365-2796
ISSN	0954-6820
DOI	10.1111/joim.13240
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Article ; Online: Authors' Reply to: COVID-19 as a "Force Majeure" for Non-COVID-19 Clinical and Translational Research. Comment on "Analysis of Scientific Publications During the Early Phase of the COVID-19 Pandemic: Topic Modeling Study".

Älgå, Andreas / Eriksson, Oskar / Nordberg, Martin

Journal of medical Internet research

2021 Volume 23, Issue 5, Page(s) e29156

MeSH term(s)	COVID-19 ; Humans ; Pandemics ; Publications ; SARS-CoV-2 ; Translational Medical Research
Language	English
Publishing date	2021-05-20
Publishing country	Canada
Document type	Letter ; Comment
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1439-4456
ISSN (online)	1438-8871
ISSN	1439-4456
DOI	10.2196/29156
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Article ; Online: Treatment Strategies and Perforation Rate of Acute Appendicitis During the Early Phase of the COVID-19 Pandemic: A Swedish Cohort Study.

Ernudd, Ivan / Älgå, Andreas / Sandblom, Gabriel / Dahlberg, Martin / Mantel, Ängla

The Journal of surgical research

2022 Volume 280, Page(s) 450–458

Abstract: Introduction: It is unknown whether the COVID-19 pandemic has had an impact on emergency surgical care in Sweden. This study aimed to compare frequency, treatment strategies, severity, and complication rate of appendicitis during the initial phase of ... ...

Abstract	Introduction: It is unknown whether the COVID-19 pandemic has had an impact on emergency surgical care in Sweden. This study aimed to compare frequency, treatment strategies, severity, and complication rate of appendicitis during the initial phase of the COVID-19 pandemic with those of previous years. Methods: In this single-center study, we identified all patients admitted with appendicitis between March 16 and June 16, 2020, at the Stockholm South General Hospital, and compared these with patients hospitalized with appendicitis during the same calendar period the three previous years. We used multivariate logistic regression to calculate Odds Ratios (OR) with 95% confidence intervals as measurement of the association between appendicitis treatment and perforation rate during the COVID-19 period compared to the nonCOVID-19 periods. Results: In all, 892 patients hospitalized with appendicitis were identified, 241 (27%) in 2020 (Covid period group) and the remaining 651 (73%) during the same calendar periods 2017-2019 (nonCovid period group). Appendicitis during the COVID-19 period was associated with double the risk for undergoing conservative treatment (OR 2.15 [95% CI 1.44-3.21]), and a decreased risk for being diagnosed with perforated appendicitis (OR 0.68 [95% CI 0.48-0.98]). Conclusions: Patients admitted with appendicitis during the early phase of the COVID-19 pandemic in Stockholm, Sweden, were more likely to receive conservative treatment and less likely to suffer from perforated appendicitis compared to patients hospitalized before the pandemic. Hypothetically, this difference could have been due to pandemic-associated resource reallocation, or it may simply reflect an increasing trend towards conservative management of appendicitis.
MeSH term(s)	Humans ; Appendicitis/epidemiology ; Appendicitis/surgery ; Appendectomy ; COVID-19/epidemiology ; Pandemics ; Sweden/epidemiology ; Cohort Studies ; Retrospective Studies ; Acute Disease
Language	English
Publishing date	2022-07-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.07.007
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Article ; Online: Exploratory laparotomy during the battle of Mosul, 2016-2017: results from a tertiary civilian hospital in Erbil, Iraqi Kurdistan.

Muhrbeck, Måns / Egelko, Aron / Haweizy, Rawand Musheer / von Schreeb, Johan / Älgå, Andreas

BMC emergency medicine

2023 Volume 23, Issue 1, Page(s) 113

Abstract: Background: The Battle of Mosul (2016-2017) was an urban conflict resulting in over 9000 civilian deaths. Emergency Management Centre (EMC), located 90 km from Mosul, was designated as a civilian-run trauma centre as part of the novel Mosul Trauma ... ...

Abstract	Background: The Battle of Mosul (2016-2017) was an urban conflict resulting in over 9000 civilian deaths. Emergency Management Centre (EMC), located 90 km from Mosul, was designated as a civilian-run trauma centre as part of the novel Mosul Trauma Pathway. Patients necessitating exploratory laparotomy (ex-lap) provide a unique window into the system of care delivery in conflicts, given the importance of timely, resource-intensive care. However, there is insufficient knowledge regarding the presentation and outcomes for conflict-related ex-lap in civilian institutions. Methods: This is a descriptive study retrospectively analyzing routinely collected data for all patients who underwent ex-lap at EMC for injuries sustained during the battle of Mosul. Differences in demographics, pre-hospital/hospital course, and New Injury Severity Scores (NISS) were analysed using student t-test, Hotelling T-squared, and linear regression. Results: During the battle, 1832 patients with conflict-related injuries were admitted to EMC. Some 73/1832 (4.0%) underwent ex-lap, of whom 22/73 (30.1%) were children and 40/73 (54.8%) were non-combatant adults. Men constituted 51/73 (69%) patients. Gunshot wounds caused 19/73 (26.0%) injuries, while ordnances caused 52/73 (71.2%). Information regarding hospital course was available for 47/73 (64.4%) patients. Children had prolonged time from injury to first laparotomy compared to adults (600 vs 208 min, p < 0.05). Median LOS was 6 days (IQR 4-9.5); however, 11/47 (23%) patients left against medical advice. Post-operative complications occurred in 11/47 (23.4%) patients; 6/11 (54.5%) were surgical site infections. There were 12 (25.5%) patients who underwent relaparotomies after index surgery elsewhere; 10/12 (83.3%) were for failed repairs or missed injuries. Median NISS was 18 (IQR 12-27). NISS were significantly higher for women (vs men; 28.5 vs 19.8), children (vs adults; 28.8 vs 20), and relaparotomy patients (vs primary laparotomy patients; 32.0 vs 19.0). Some 3 patients died, 2 of whom were relaparotomies. Conclusion: At this civilian tertiary trauma centre, conflict-related exploratory laparotomies were associated with low morbidity and mortality. Long transport times, high rates of repeat laparotomies, and high numbers of patients leaving against medical advice raise questions regarding continuity of care along the Mosul Trauma Pathway. Trial registration: The study protocol was registered at Clinicaltrails.gov, ID NCT03490305, prior to collection of data.
MeSH term(s)	Adult ; Male ; Child ; Humans ; Female ; Laparotomy ; Wounds, Gunshot/surgery ; Retrospective Studies ; Iraq/epidemiology ; Hospitals ; Abdominal Injuries/surgery
Language	English
Publishing date	2023-09-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2050431-7
ISSN	1471-227X ; 1471-227X
ISSN (online)	1471-227X
ISSN	1471-227X
DOI	10.1186/s12873-023-00882-y
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Article ; Online: Wound specific quality of life after blast or gunshot injury

Andreas Älgå / Jonas Malmstedt / Ann-Mari Fagerdahl

PLoS ONE, Vol 17, Iss

Validation of the wound QoL instrument

2022 Volume 10

Abstract: Background Acute blast or gunshot wounds have a negative effect on the patients’ health related quality of life (HRQoL). No validated instrument exists to assess the HRQoL of patients with such wounds. Therefore, we aimed to test and validate a subscale ... ...

Abstract	Background Acute blast or gunshot wounds have a negative effect on the patients’ health related quality of life (HRQoL). No validated instrument exists to assess the HRQoL of patients with such wounds. Therefore, we aimed to test and validate a subscale of an existing HRQoL instrument among patients with acute blast or gunshot wounds. Methods We used data from a randomized controlled trial comparing negative pressure wound therapy with standard treatment of civilian adults with acute extremity blast or gunshot wounds. We evaluated the reliability (internal consistency, stability) and validity of the body subscale of the Wound QoL instrument using the World Health Organisation 20 question self-reporting questionnaire as gold standard. Results A total of 152 participants were included in the study. The participants were predominantly (93.4%) male, and median age was 29.0 years (IQR 21.0–34.0). The internal consistency was acceptable while a test-retest analysis indicated instability in the Wound QoL instrument. The content validity of the instrument was considered satisfactory; however, the criterion validity was found to be insufficient. Conclusions Our results indicate that Wound QoL is a promising instrument for the assessment of wound specific HRQoL among patients with acute blast or gunshot wounds. Further testing and validation is needed.
Keywords	Medicine ; R ; Science ; Q
Subject code	150
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
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Article ; Online: Author's Reply: a Last Resort When There is No Blood: Experiences and Perceptions of Intraoperative Autotransfusion Among Medical Doctors Deployed to Resource-Limited Settings.

Sjöholm, Annie / Älgå, Andreas / von Schreeb, Johan

World journal of surgery

2020 Volume 45, Issue 2, Page(s) 651

MeSH term(s)	Blood Transfusion, Autologous ; Humans ; Perception
Language	English
Publishing date	2020-11-29
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-020-05879-3
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