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  1. Article: Managing appendicitis during the COVID-19 era: A single centre experience & implications for future practice.

    Bajomo, Oreoluwa / Hampal, Rumneek / Sykes, Paul / Miah, Anur

    Annals of medicine and surgery (2012)

    2021  Volume 63, Page(s) 102168

    Abstract: Aim: During the COVID-19 pandemic, emergency surgery was modified in line with Royal College guidance to accommodate the evolving climate. This study compared management of appendicitis before and during the pandemic by assessing disease presentation ... ...

    Abstract Aim: During the COVID-19 pandemic, emergency surgery was modified in line with Royal College guidance to accommodate the evolving climate. This study compared management of appendicitis before and during the pandemic by assessing disease presentation severity, modes of investigation, surgical management and patient outcomes. Outcomes assessed included length of stay, readmissions and rates of postoperative wound infections.
    Methods: We collected data on appendicitis patients managed at a district general hospital over two distinct 8-week periods; 42 patients before and 36 patients during the COVID-19 pandemic respectively. The study included clinically or radiologically diagnosed appendicitis patients.
    Results: Our study found patients during the COVID-19 pandemic had higher inflammatory markers (CRP 103 vs 53 mg/L; p = 0.03) and more severe disease on histological examination of the appendix than pre-pandemic. Patients were nearly twice as likely to undergo CT diagnosis of appendicitis during the pandemic than before. During the pandemic, only half of the cohort underwent laparoscopic appendicectomy in contrast with greater than 85% of the pre-COVID-19 cohort (p = 0.0005). Patients in the COVID-19 era cohort recorded shorter lengths of hospital stay (2.6 vs 3 days; p = 0.35); however, had higher reattendance rates (12 vs 25%; p = 0.15) and surgical site infections (p = 0.0443). Finally, the study reported shorter median time to theatre (0 vs 1 days) during the pandemic than before.
    Conclusion: In addition to reiterating the benefits of laparoscopic versus open surgery and quicker diagnostic methods, this study also implies that though patients during COVID-19 era presented with more severe disease, their treatment was in a more efficient service.
    Language English
    Publishing date 2021-02-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2021.02.014
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  2. Article: Surgical consent during the COVID-19 pandemic.

    Rotimi, O / Beatson, K / Aderombi, A / Lam, W / Bajomo, O / Kukreja, N

    Annals of medicine and surgery (2012)

    2020  Volume 59, Page(s) 229–233

    Abstract: Background and aims: During the COVID-19 pandemic, surgical practice may deviate with operative and non-operative management considered. Appropriate discussion of options with patients is paramount to quality surgical care. Intercollegiate and EAES ... ...

    Abstract Background and aims: During the COVID-19 pandemic, surgical practice may deviate with operative and non-operative management considered. Appropriate discussion of options with patients is paramount to quality surgical care. Intercollegiate and EAES guidelines recommend discussing and documenting risk of COVID-19 exposure in the consent process for patients undergoing surgery.
    Materials and methods: Closed-loop audit of consent forms for patients undergoing emergency and elective surgical procedures. Interventions implemented included education of wider surgical teams. Data was collected during a one-week period for each cycle and analysed using Chi-squared test.
    Results: In cycle 1, 6/17 (35.3%) case notes documented discussion of COVID-19 risk. Following intervention, compliance improved to 23/29 (79.3%) cases in cycle 2 and 33/45 (73.3%) cases in cycle 3.
    Conclusion: Pre-intervention, our consenting practice was non-compliant. Our interventions led to significant and sustained improvements in practice. We recommend provision of wider surgical team education to facilitate good consenting practice.
    Keywords covid19
    Language English
    Publishing date 2020-10-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2020.10.011
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  3. Article: Surgical consent during the COVID-19 pandemic

    Rotimi, O / Beatson, K / Aderombi, A / Lam, W / Bajomo, O / Kukreja, N

    Ann Med Surg (Lond)

    Abstract: Background and aims: During the COVID-19 pandemic, surgical practice may deviate with operative and non-operative management considered. Appropriate discussion of options with patients is paramount to quality surgical care. Intercollegiate and EAES ... ...

    Abstract Background and aims: During the COVID-19 pandemic, surgical practice may deviate with operative and non-operative management considered. Appropriate discussion of options with patients is paramount to quality surgical care. Intercollegiate and EAES guidelines recommend discussing and documenting risk of COVID-19 exposure in the consent process for patients undergoing surgery. Materials and methods: Closed-loop audit of consent forms for patients undergoing emergency and elective surgical procedures. Interventions implemented included education of wider surgical teams. Data was collected during a one-week period for each cycle and analysed using Chi-squared test. Results: In cycle 1, 6/17 (35.3%) case notes documented discussion of COVID-19 risk. Following intervention, compliance improved to 23/29 (79.3%) cases in cycle 2 and 33/45 (73.3%) cases in cycle 3. Conclusion: Pre-intervention, our consenting practice was non-compliant. Our interventions led to significant and sustained improvements in practice. We recommend provision of wider surgical team education to facilitate good consenting practice.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #845879
    Database COVID19

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  4. Article ; Online: Surgical consent during the COVID-19 pandemic

    Rotimi, O. / Beatson, K. / Aderombi, A. / Lam, W. / Bajomo, O. / Kukreja, N.

    Annals of Medicine and Surgery

    2020  Volume 59, Page(s) 229–233

    Keywords covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1016/j.amsu.2020.10.011
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Ablation guided by STAR-mapping in addition to pulmonary vein isolation is superior to pulmonary vein isolation alone or in combination with CFAE/linear ablation for persistent AF.

    Honarbakhsh, Shohreh / Schilling, Richard J / Providencia, Rui / Dhillon, Gurpreet / Bajomo, Omotomilola / Keating, Emily / Finlay, Malcolm / Hunter, Ross J

    Journal of cardiovascular electrophysiology

    2021  Volume 32, Issue 2, Page(s) 200–209

    Abstract: Introduction: The optimal ablation approach for persistent atrial fibrillation (AF) remains unclear.: Methods and results: Objective was to compare the long-term rates of freedom from AF/AT in patients that underwent STAR mapping guided ablation ... ...

    Abstract Introduction: The optimal ablation approach for persistent atrial fibrillation (AF) remains unclear.
    Methods and results: Objective was to compare the long-term rates of freedom from AF/AT in patients that underwent STAR mapping guided ablation against outcomes of patients undergoing conventional ablation procedures. Patients undergoing ablation for persistent AF as part of the Stochastic Trajectory Analysis of Ranked signals (STAR) mapping study were included. Outcomes following 'pulmonary vein isolation (PVI) plus STAR mapping guided ablation (STAR mapping cohort) were compared to patients undergoing PVI alone ablation during the same time period and also a propensity-matched cohort undergoing PVI plus the addition of complex fractionated electrogram (CFAE) and/or linear ablation ("conventional ablation"). Rates of procedural AF termination and freedom from AF/AT during follow-up were compared. Sixty-five patients were included in both the STAR cohort and propensity matched conventional ablation cohort. AF termination rates were significantly higher in the STAR cohort (51/65, 78.5%) than conventional ablation cohort (10/65, 15.4%) and PVI alone ablation cohort (13/50, 26.0%; STAR cohort vs. other 2 cohorts both p < .001). There was no significant difference in procedure time between the three cohorts. During ≥20 months follow-up a lower proportion of patients had AF/AT recurrence in the STAR cohort (20.0%) compared with the conventional ablation cohort (50.8%) or the PVI alone ablation cohort (50.0%; both p < .05 compared to STAR cohort).
    Conclusions: Outcomes of PVI plus STAR mapping guided ablation was superior to PVI alone or in combination with linear/CFAE ablation. A multicenter randomized controlled trial is planned to confirm these findings.
    MeSH term(s) Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Catheter Ablation/adverse effects ; Humans ; Pulmonary Veins/diagnostic imaging ; Pulmonary Veins/surgery ; Recurrence ; Treatment Outcome
    Language English
    Publishing date 2021-01-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1025989-2
    ISSN 1540-8167 ; 1045-3873
    ISSN (online) 1540-8167
    ISSN 1045-3873
    DOI 10.1111/jce.14856
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2863: Show issues Location:
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  6. Article ; Online: A meta-analysis of literacy and language in children with rolandic epilepsy.

    Smith, Anna B / Bajomo, Omotomilola / Pal, Deb K

    Developmental medicine and child neurology

    2015  Volume 57, Issue 11, Page(s) 1019–1026

    Abstract: Aim: Rolandic epilepsy is the most common childhood epilepsy, often presenting with neuropsychological impairments. The aim of the study was to formally assimilate the findings of existing studies varying widely in methodology, thereby confirming the ... ...

    Abstract Aim: Rolandic epilepsy is the most common childhood epilepsy, often presenting with neuropsychological impairments. The aim of the study was to formally assimilate the findings of existing studies varying widely in methodology, thereby confirming the nature and prevalence of impairments in literacy and language.
    Methods: Using meta-analytical techniques, we evaluated 22 studies of literacy and/or language skills in children with rolandic epilepsy, published after 2000, among participants with IQs>70 and in which effect sizes could be acquired. Diagnosis required the presence of classical centrotemporal spikes arising from a normal background on electroencephalograms; a clinical history including at least one seizure; and no additional neurological condition. Overall effect size and heterogeneity were measured for single-word reading, phonological processing, and expressive and receptive language.
    Results: Mean effect sizes (Cohen's d) ranged from 0.50 (95% confidence interval [CI] 0.23-0.78) for phonological processing, through 0.71 (95% CI 0.52-0.90) for word reading and 0.72 (95% CI 0.34-1.1) for receptive language, to 0.75 (95% CI 0.45-1.05) for expressive language. While group differences for reading measures were consistent, those for language were heterogeneous and varied across studies explained by age and IQ of samples.
    Interpretation: The presence of reading and phonological processing deficits in children with rolandic epilepsy highlights the importance of early literacy and language assessment in this population.
    MeSH term(s) Child ; Databases, Bibliographic/statistics & numerical data ; Epilepsy, Rolandic/complications ; Epilepsy, Rolandic/diagnosis ; Humans ; Language Development Disorders/etiology ; Linguistics ; Literacy
    Language English
    Publishing date 2015-11
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 80369-8
    ISSN 1469-8749 ; 0012-1622
    ISSN (online) 1469-8749
    ISSN 0012-1622
    DOI 10.1111/dmcn.12856
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    Zs.B 5: Show issues Location:
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  7. Article ; Online: Clinical and echocardiographic predictors of decompensation in acute severe aortic regurgitation due to infective endocarditis.

    Chasapi, Athina / Mbonye, Kamatamu A / Bajomo, Omotomilola / Young, William J / Primus, Christopher / Ambekar, Shirish / Wong, Kit / Uppal, Rakesh / Davies, Lewis Ceri / Khanji, Mohammed Y / Woldman, Simon / Lloyd, Guy / Bhattacharyya, Sanjeev

    Echocardiography (Mount Kisco, N.Y.)

    2021  Volume 38, Issue 4, Page(s) 590–595

    Abstract: Background: Patients with acute severe aortic regurgitation (AR) due to infective endocarditis can progress rapidly from the hemodynamically stable patient to pulmonary edema and cardiogenic shock. We sought to identify patients at risk of ... ...

    Abstract Background: Patients with acute severe aortic regurgitation (AR) due to infective endocarditis can progress rapidly from the hemodynamically stable patient to pulmonary edema and cardiogenic shock. We sought to identify patients at risk of decompensation where emergent surgery should be undertaken.
    Methods: We identified 90 patients with acute severe AR from the echocardiography laboratory database. Baseline clinical, hemodynamic (heart rate (HR) and blood pressure (BP)), and echocardiographic data including mitral filling, premature mitral valve closure (PMVC), and diastolic mitral regurgitation (DMR) were identified. The primary endpoint was subsequent development of pulmonary edema or severe hemodynamic instability.
    Results: Patients who met the primary endpoint had a higher HR (98.5 bpm vs 80.5 bpm), lower diastolic BP (54 mm Hg vs 61.5 mm Hg), higher mitral E-wave velocity (113 cm/s vs 83 cm/s), higher E/e' ratio (12.4 vs 8), higher proportion of DMR (27.8% vs 7.4%), and PMVC (25% vs 9.3%) than patients who did not meet the endpoint. The proportion of patients with the primary endpoint increased as HR increased ((≤81 bpm) 3/30 (10%), (81-94 bpm) 11/31 (35.5%), (≥94 bpm) 22/29 (75.9%), P < .0001) and as the diastolic BP reduced ((≤54 mm Hg) 19/31 (61.3%), (54-63 mm Hg) 12/31 (38.7%), (≥63 mm Hg) 5/28 (17.9%), P = .003). Independent predictors were a higher HR (OR 1.08 (95% CI 1.04-1.13) P = .0003) and DMR (OR 4.71 (95% CI 1.23-18.09), P = .02).
    Conclusion: Decompensation in acute severe AR is common. Independent predictors of decompensation are increasing HR(≥94 bpm) and the presence of DMR. Those with these adverse markers should be considered for emergent surgery.
    MeSH term(s) Aortic Valve Insufficiency/complications ; Aortic Valve Insufficiency/diagnostic imaging ; Echocardiography ; Endocarditis, Bacterial ; Humans ; Mitral Valve ; Mitral Valve Insufficiency
    Language English
    Publishing date 2021-03-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 843645-9
    ISSN 1540-8175 ; 0742-2822
    ISSN (online) 1540-8175
    ISSN 0742-2822
    DOI 10.1111/echo.15028
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  8. Article ; Online: Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection

    Nepogodiev D. / Bhangu A. / Glasbey J.C. / Li E. / Omar O.M. / Simoes J.F. / Abbott T.E. / Alser O. / Arnaud A.P. / Bankhead-Kendall B.K. / Breen K.A. / Cunha M.F. / Davidson G.H. / Di Saverio S. / Gallo G. / Griffiths E.A. / Gujjuri R.R. / Hutchinson P.J. / Kaafarani H.M. /
    Lederhuber H. / Loffler M.W. / Mashbari H.N. / Minaya-Bravo A. / Morton D.G. / Moszkowicz D. / Pata F. / Tsoulfas G. / Venn M.L. / Cox D. / Roslani A.C. / Alakaloko F. / de Vries J.-P.P. / Aaraj M.A. / Abbott S.J. / Abdalla M.O. / Abdelaal A.S. / Ademuyiwa A.O. / Aherne T.M. / Ali O.M. / Alkadeeki G.Z. / Almeida A.C. / Alrahawy M.M. / Ambler G.K. / Alameer E. / Andreani S.M. / De Andres-Asenjo B. / Antonanzas L.L. / Aoun S.G. / Ashoush F.M. / Augestad K.M. / Avellana R.B. / Ayeni F.A. / Ayorinde J.O. / Babu B.H. / Baig M.M. / Bajomo O.M. / Baker O.J. / Baker M.P. / Baldwin A.J. / Ban V.S. / Baron R.D. / Barranquero A.G. / Barry C.P. / DI Bartolomeo A. / Bass G.A. / Bath M.F. / Batjer H.H. / Beamish A.J. / Belgaumkar A.P. / Bence M.N. / Benson R.A. / Bernal-Sprekelsen J.C. / Bhama A.R. / Bhavaraju A.V. / Biffl W.L. / Blundell C.M. / Boddy A.P. / Borgstein A.B. / Bosanquet D.C. / Bosch K.D. / Bouhuwaish A.E. / Bozkurt M.A. / Brathwaite C.E. / Brown B.C. / Brown O.D. / Brown A.K. / Buarque I.L. / Bueno-Canones A.D. / Bulugma M.R. / Burke J.R. / Byrne M.H. / Cagigal-Ortega E.P. / Callcut R.A. / DI Candido F. / Canova M.E. / Carlos W.J. / Caruana E.J. / Cato L.D. / Catton A.B. / Ceretti A.P. / Chase T.J. / Chiara F.D. / Chowdhury A.H. / Chung E.A. / Cicerchia P.M. / Clough E.C. / Coleman N.L. / Collins C.G. / Collins M.L. / Colonna E.T. / Comini L.V. / Coughlin P.A. / Cruzado L.F.-G. / Davidson B.R. / Davies R.J. / Davies E.J. / Davis N.F. / Dawson B.E. / Dean B.J. / Delgado M.G.-C. / Diaz J.J. / Dickson K.E. / Diez-Alonso M.M. / Dixon J.R. / Doe M.J. / Drake T.D. / Drake F.T. / Duffy J.P. / Dunne D.F. / Dunne N.J. / Duran-Munoz-Cruzado V.M. / Durst A.Z. / Eardley N.J. / Edwards J.G. / Elfallal A.H. / Elfiky M.M. / Elliott J.A. / Emile S.H. / Emslie K.M. / Endorf F.W. / Engel J.L. / Enjuto D.T. / Etchill E.W. / Evans J.P. / Fahey B.A. / Faria C.S. / Feo C.V. / Ferguson H.J. / Fernandez B.D. / Fernandez A.G. / Fernandez A.J. / Fernandez-Pacheco B.C. / Fitzgerald 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Gomez Diaz C.J. / Garcia Galocha J.L. / de Gheldere C.A. / Ataide Gomes G.M. / Beltran de Heredia J. / Blazer III D.G. / Nugent III W.C. / Ali karar A.A. / Borja De Lacy F. / Blas Laina J.L. / Shane Lester M.J. / Liyanage A.S.D. / Al Maadany F.S. / De Marchi J.A. / Ramos-De la Medina A. / Mithany R.H.M. / Sanchez del Pueblo C. / van Ramshorst G.H. / De Salas M.M. / De Souza A.C. / Dolores Del Toro M. / Archer J.E. / Odeh A. / Erridge S. / Salem H.K. / Jones G.P. / Gardner A. / Tripathi S.S. / Gregg A. / Jeganathan R. / Siddique M.H. / Lombardi C.P. / Martin B. / Leo C.A. / Dass D. / Di Franco G. / Jiao L.R. / Mari G.M. / Capitan-Morales L.-C. / Connelly T.M. / Alanbuki A. / De Virgilio A. / Schilling C. / San Miguel Mendez C. / Kulkarni G. / Nizami K. / Walsh S. / Dean H. / Ruiz-Marin M. / Houston R. / Trompetto M. / Chrastek D. / Kouritas V. / Cannoletta M. / Rosato F. / Kaushal M.V. / Costa P.M. / Elkadi H.H. / Johnstone J.R. / Irvine E. / Alvarez M.R. / Corbellini C. / Venkatesan G.S. / Mateo-Sierra O. / Martinez-Perez C. / Serrano Gonzalez J. / Hernandez Bartolome M.A. / Diaz Perez D. / Gutierrez Samaniego M. / Galindo Jara P. / Sharma N. / Smart N.J. / Keller D.S.

    an international cohort study

    2020  

    Abstract: Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and ... ...

    Abstract Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p<0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p<0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
    Keywords Adult ; Aged ; Betacoronavirus ; Coronavirus Infections ; Elective Surgical Procedures ; Emergency Medical Services ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia ; Viral ; Postoperative Complications ; Respiratory Tract Diseases ; Retrospective Studies ; Surgical Procedures ; Operative ; Young Adult ; covid19
    Subject code 610 ; 616
    Language English
    Publishing country it
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection

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del Pueblo, C / van Ramshorst, GH / De Salas, MM / De Souza, AC / Dolores Del Toro, M / Archer, JE / Odeh, A / Erridge, S / Salem, HK / Jones, GP / Gardner, A / Tripathi, SS / Gregg, A / Jeganathan, R / Siddique, MH / Lombardi, CP / Martin, B / Leo, CA / Dass, D / Di Franco, G / Jiao, LR / Mari, GM / Capitan-Morales, LC / Connelly, TM / Alanbuki, A / De Virgilio, A / Schilling, C / San Miguel Mendez, C / Kulkarni, G / Nizami, K / Walsh, S / Dean, H / Ruiz-Marin, M / Houston, R / Trompetto, M / Chrastek, D / Kouritas, V / Cannoletta, M / Rosato, F / Kaushal, MV / Costa, PM / Elkadi, HH / Johnstone, JR / Irvine, E / Alvarez, MR / Corbellini, C / Venkatesan, GS / Mateo-Sierra, O / Martínez-Pérez, C / Serrano González, J / Hernández Bartolomé, MÁ / Díaz Pérez, D / Gutiérrez Samaniego, M / Galindo Jara, P / Sharma, N / Smart, NJ / Keller, DS

    an international cohort study

    2020  

    Abstract: Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and ... ...

    Abstract Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
    Keywords covid19
    Language English
    Publisher Elsevier
    Publishing country uk
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Delaying surgery for patients with a previous SARS-CoV-2 infection

    Glasbey, J. C. / Nepogodiev, D. / Omar, O. / Simoes, J. F. F. / Ademuyiwa, A. / Fiore, M. / Minaya-Bravo, A. / Shaw, R. / Vidya, R. / Bhangu, A. / Bhangu, A. A. / Siaw-Acheampong, K. / Benson, R. / Bywater, E. / Chaudhry, D. / Dawson, B. E. / Evans, J. P. / Gujjuri, R. R. / Heritage, E. /
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    2020  

    Keywords covid19
    Language English
    Publishing country it
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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