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Objective: To test the hypothesis that the degree and duration of alterations in physiological variables routinely gathered by intensive care unit (ICU) monitoring systems during the first day of admission to the ICU, together with a few additional routinely recorded data, yield information similar to that obtained by traditional mortality prediction systems. Design: A prospective observational multicenter study (EURICUS II) was carried out. Setting: Fifty-five European ICUs. Patients: A total of 17,598 consecutive patients admitted to the ICU over a 10-month period. Interventions: None. Main variables of interest: Hourly data were manually gathered on alterations or "events" in systolic blood pressure, heart rate and oxygen saturation throughout ICU stay to construct an events index and mortality prediction models. Results: The mean first-day events index was 6.37±10.47 points, and was significantly associated to mortality (p

Objetivo. Averiguar cuál es el grado de actividad en el campo de la prevención secundaria en traumatizados relacionados con alcohol y drogas en el territorio español. Material y método. Encuesta a 76 hospitales de todas las comunidades autónomas del país, solicitando información sobre número de pacientes traumatizados graves que requerían ingreso en UCI por año, la detección de alcohol y drogas en estos pacientes y la actividad en prevención secundaria mediante intervención motivacional, entre otras. Resultados. De los 76 hospitales encuestados, 66 respondieron y tan sólo uno realizaba alguna actividad de prevención secundaria mediante intervención motivacional. La mayoría de los encuestados (64,5% [40/62]) desconocían esta posibilidad y el 29% no la realizaba por falta de medios (18/62). El 15,6% de los centros realiza siempre análisis de alcohol y drogas en traumatizados. El 37,5% (24/64) admite realizar estas pruebas en la "mayoría" de los pacientes, y un 40,6% sólo lo realiza "a veces". Conclusión. La mayoría de los encuestados desconoce la utilidad de la prevención secundaria en traumatizados. Este desconocimiento puede ser causante de la nula actividad que se detecta en España en este campo. Es necesario un plan de difusión con acciones educacionales para promocionar este tipo de actividades. Objective. To determine the degree of activity in the field of secondary prevention of alcohol and/or drug abuse in trauma patients in Spain. Material and methods. We surveyed 76 hospitals located in all the autonomous regions of Spain. We collected information about the number of severe trauma patients admitted to the ICU per year, the detection of alcohol and drugs in these patients, and the activity for secondary prevention through motivational intervention among other approaches. Results. Of the 76 hospitals surveyed, 66 responded and only one carried out any secondary prevention activity through motivational intervention. Most of the hospitals surveyed (64.5%, 40/62) did not know of the possibility of secondary prevention through motivational intervention and (29%, 18/62) did not have the resources to carry it out. Asked whether they screened trauma patients for drugs and/or alcohol, 15.6% of centers responded "always" 37.5% (24/64) "usually", and 40.6% only "sometimes". Conclusion. Most centers surveyed are unaware of the usefulness of secondary prevention in trauma patients. This lack of awareness may be responsible for the lack of activity in this field in Spain. A plan to increase awareness, including educational interventions, is necessary to promote secondary prevention of alcohol and drug abuse among trauma patients.