A Cohort Study in Intensive Care Units: Health Decisions Related to Blood Transfusion during the COVID-19 Pandemic.

Critically ill polytrauma patients with hemorrhage require a rapid assessment to initiate hemostatic resuscitation in the shortest possible time with the activation of a massive transfusion or a critical hemorrhage management protocol. The hospital reality experienced during the COVID-19 pandemic in all countries was critical, as it was in Spain; according to the data published daily by the Ministry of Health on its website, during the period of this study, the occupancy rate of intensive care units (ICUs) by patients diagnosed with the novel coronavirus disease (COVID-19) rose to 23.09% in Spain, even reaching 45.23% at the end of January 2021. We aimed to analyze the changes observed during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic period regarding the effectiveness of Spanish ICUs in terms of mortality reduction. We present a cross-sectional study that compares two cohorts of patients admitted to ICUs across all autonomous communities of Spain with a diagnosis of polytrauma. Results: Only age was slightly higher at admission during the first wave of the pandemic (47.74 ± 18.65 vs. 41.42 ± 18.82 years, p = 0.014). The transfusion rate during the pandemic increased by 10.4% compared to the previous stage (p = 0.058). Regarding hemostatic components, the use of tranexamic acid increased from 1.8% to 10.7% and fibrinogen concentrates from 0.9% to 1.9%. In the case of prothrombin complex concentrates, although there was a slight increase in their use, there were no significant differences during the pandemic compared to the previous period. Conclusion: Mortality showed no difference before and during the pandemic, despite the observed change in the transfusion policy. In summary, the immediate and global implementation of patient blood management (PBM) based on clinical transfusion algorithms should be mandatory in all hospitals in our country.

Psychological impact on care professionals due to the SARS-Cov-2 virus in Spain.

OBJECTIVE: To analyze the psychological impact of the SARS-Cov-2 pandemic on nurses in Spain in three different dimensions: exposure to stressors, perceived emotions, and stress coping. BACKGROUND: On March 11, 2019, the World Health Organization recognized a global pandemic caused by a SARS-Cov-2 virus, COVID-19, which rapidly spread across the planet, involving a community health emergency of international scope. INTRODUCTION: The pandemic situation in health centers has led to significant changes in the work environment, compromising care professionals' physical and psychological health and resulting in strong physical and mental exhaustion. METHODS: An observational, descriptive, cross-sectional study was carried out, between February and April 2021, in a large sample of 1360 participants. The researchers conducted the dissemination of a validated questionnaire to working nurses in Spain. RESULTS: The sex variable in relation to the study dimensions (stressors, perceived emotions, and coping strategies) showed a mean for stressors of 62.2 ± 10.5 in women and 59.8 ± 12.5 in men (p = 0.010), showing statistically significant differences. Age was a protective factor for all dimensions (p < 0.001). Time of experience showed statistically significant differences for stressors and coping strategies in professionals with more than 15 years of experience. DISCUSSION: Female nurses who are younger, have less work experience, have not built a family of their own, and live in smaller or indoor flats may be more vulnerable to the effects of the COVID-19 pandemic on their mental health. Other national and international studies, in this line, have shown an important psychological impact on these professionals. CONCLUSION: It is necessary to design and adopt effective strategies and measures for the protection of nurses' mental health, as well as for the prevention and early diagnosis of possible mental health problems.

The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has become one of the leading causes of death worldwide. The impact of poor nutritional status on increased mortality and prolonged ICU (intensive care unit) stay in critically ill patients is well-documented. This study aims to assess how nutritional status and BMI (body mass index) affected in-hospital mortality in critically ill COVID-19 patients Methods: We conducted a retrospective study and analysed medical records of 286 COVID-19 patients admitted to the intensive care unit of the University Clinical Hospital in Wroclaw (Poland). RESULTS: A total of 286 patients were analysed. In the sample group, 8% of patients who died had a BMI within the normal range, 46% were overweight, and 46% were obese. There was a statistically significantly higher death rate in men (73%) and those with BMIs between 25.0-29.9 (p = 0.011). Nonsurvivors had a statistically significantly higher HF (Heart Failure) rate (p = 0.037) and HT (hypertension) rate (p < 0.001). Furthermore, nonsurvivors were statistically significantly older (p < 0.001). The risk of death was higher in overweight patients (HR = 2.13; p = 0.038). Mortality was influenced by higher scores in parameters such as age (HR = 1.03; p = 0.001), NRS2002 (nutritional risk score, HR = 1.18; p = 0.019), PCT (procalcitonin, HR = 1.10; p < 0.001) and potassium level (HR = 1.40; p = 0.023). CONCLUSIONS: Being overweight in critically ill COVID-19 patients requiring invasive mechanical ventilation increases their risk of death significantly. Additional factors indicating a higher risk of death include the patient's age, high PCT, potassium levels, and NRS ≥ 3 measured at the time of admission to the ICU.

Psychometric Properties and Cultural Adaptation of the Polish Version of the Healthy Lifestyle and Personal Control Questionnaire (HLPCQ).

BACKGROUND: Chronic non-communicable diseases (NCDs), sometimes referred to as lifestyle diseases, are the most common cause of death and disability worldwide. Thus, healthcare professionals should be equipped with tools, knowledge, skills, and competencies in the newly distinguished field of lifestyle medicine. The purpose of this study was to test the psychometric properties of the Polish version of the Healthy Lifestyle and Personal Control Questionnaire (HLPCQ). The Polish version of the HLPCQ would further provide Polish healthcare professionals with a useful and convenient tool for routine lifestyle assessment while giving HLPCQ novel use and potential for further research. METHODS: Before testing its psychometric properties, the HLPCQ was translated and adapted from the original Greek version into Polish. Subsequently, we tested the instrument's psychometric properties on a sample of 2433 participants. In addition, we tested the factorial validity of the HLPCQ using confirmatory and exploratory factor analysis. RESULTS: There were more female than male participants (91.78%). Most of them were middle-aged (30.40 ± 7.71), single (39.62%), and living with family (70.65%). In terms of residence, 1122 (46.12%) participants lived in cities with a population of over 500,000. In terms of reliability, the internal consistency of the Polish version and its domains is excellent. Cronbach's alpha for each of the domains of the scale ranged between 0.6 and 0.9. CONCLUSIONS: The Polish version of the Healthy Lifestyle and Personal Control Questionnaire (HLPCQ) has good characteristics of factorial validity and can be used in clinical practice and research.