ESTES recommendations for the treatment of polytrauma-a European consensus based on the German S3 guidelines for the treatment of patients with severe/multiple injuriesRey Valcarcel, Cristina (Avtor) Bieler, Dan (Avtor) Bass, Gary A. (Avtor) Gaarder, Christine (Avtor) Hildebrand, Frank (Avtor) Tomaževič, Matevž (Sodelavec pri raziskavi) polytraumainjuryguidelinesrecommendationsconsensusIntroduction: 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.20252026-05-20 14:51:31Neznano29483UDK: 616-083.98ISSN pri članku: 1863-9941DOI: 10.1007/s00068-025-02852-4COBISS_ID: 278817027sl