Articles: postoperative-complications.
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Multicenter Study Observational Study
First experience of SARS-CoV-2 infections in solid organ transplant recipients in the Swiss Transplant Cohort Study.
Immunocompromised patients may be at increased risk for complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, comprehensive data of SARS-CoV-2 infection in solid organ transplant (SOT) recipients are still lacking. We performed a multicenter nationwide observational study within the Swiss Transplant Cohort Study (STCS) to describe the epidemiology, clinical presentation, treatment and outcomes of the first microbiologically documented SARS-CoV-2 infection among SOT recipients. ⋯ After a median of 33 days of follow-up, 16 patients were discharged, 3 were still hospitalized and 2 patients died. These data suggest that clinical manifestations of SARS-CoV-2 infection in middle-aged SOT recipients appear to be similar to the general population without an apparent higher rate of complications. These results need to be confirmed in larger cohorts.
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Co-morbidities in colorectal cancer patients complicate hospital care, and their relative importance to post-operative deaths is largely unknown. This study was conducted to examine a range of clinical and sociodemographic factors in relation to post-operative in-hospital deaths in colorectal cancer patients and identify whether these contributions would vary by severity of co-morbidities. ⋯ Identification of relative importance of factors contributing to in-hospital deaths in colorectal cancer patients using ANN may help to enhance patient-centred strategies to meet complex needs during acute surgical care and prevent post-operative in-hospital deaths.
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Multicenter Study Comparative Study
Self-expanding intra-annular versus commercially available transcatheter heart valves in high and extreme risk patients with severe aortic stenosis (PORTICO IDE): a randomised, controlled, non-inferiority trial.
Randomised trial data assessing the safety and efficacy of the self-expanding intra-annular Portico transcatheter aortic valve system (Abbott Structural Heart, St Paul, MN, USA) compared with any commercially available valves are needed to compare performance among designs. ⋯ Abbott.
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Randomized Controlled Trial Multicenter Study
Individualized PEEP to optimise respiratory mechanics during abdominal surgery: a pilot randomised controlled trial.
Higher intraoperative driving pressures (ΔP) are associated with increased postoperative pulmonary complications (PPC). We hypothesised that dynamic adjustment of PEEP throughout abdominal surgery reduces ΔP, maintains positive end-expiratory transpulmonary pressures (Ptp_ee) and increases respiratory system static compliance (Crs) with PEEP levels that are variable between and within patients. ⋯ NCT02671721.
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The bone & joint journal · Sep 2020
Multicenter StudyThe effects of COVID-19 on perioperative morbidity and mortality in patients with hip fractures.
During the COVID-19 pandemic, many patients continue to require urgent surgery for hip fractures. However, the impact of COVID-19 on perioperative outcomes in these high-risk patients remains unknown. The objectives of this study were to establish the effects of COVID-19 on perioperative morbidity and mortality, and determine any risk factors for increased mortality in patients with COVID-19 undergoing hip fracture surgery. ⋯ Hip fracture surgery in COVID-19-positive patients was associated with increased length of hospital stay, more admissions to the critical care unit, higher risk of perioperative complications, and increased mortality rates compared to COVID-19-negative patients. Risk factors for increased mortality in patients with COVID-19 undergoing surgery included positive smoking status and multiple (greater than three) comorbidities. Cite this article: Bone Joint J 2020;102-B(9):1136-1145.