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  1. Article ; Online: Recreational off-highway vehicle crashes resulting in victims being treated at a regional trauma center

    Charles A. Jennissen / Meaghan T. Reaney / Gerene M. Denning

    Injury Epidemiology, Vol 7, Iss S1, Pp 1-

    mechanisms and contributing factors

    2020  Volume 10

    Abstract: Abstract Background Recreational off-highway vehicles (ROVs) have become increasingly popular in recent years; however, crash epidemiology is not well described. ROVs travel at least 30 mph, and unlike all-terrain vehicles, have a rollover protective ... ...

    Abstract Abstract Background Recreational off-highway vehicles (ROVs) have become increasingly popular in recent years; however, crash epidemiology is not well described. ROVs travel at least 30 mph, and unlike all-terrain vehicles, have a rollover protective structure (ROPS) and seat belts or a harness system for occupants. This study’s objective was to evaluate the demographics, mechanisms, injuries, and associated risk factors of ROV crashes. Methods A retrospective chart review was performed for patients of all ages with ROV-related injuries presenting to a Level 1 trauma center from 2004 to 2017. Cases were identified by ICD-9/10 codes and narrative searches. Person- and crash-related variables were examined in relation to injury outcomes including body area injured, injury severity score, and disposition (e.g. hospitalization, intensive care unit admission). Descriptive, bivariate (chi-square, Fishers exact test), and linear regression analyses were performed. Results Seventy-two patients with ROV-related injuries were identified. The number of injured patients increased over the study period (p < 0.01). Patients were 49% youth < 16 years old, 63% males, and 99% Caucasian. Half of the injured (51%) were passengers, with a higher proportion of youth being passengers (70%) as compared to adults (35%) (p < 0.01). Nearly one-third (30%) of crash victims < 16 years old were ROV drivers. Twenty-nine percent of all crashes occurred on roadways. Almost 40% of injured adults crashed at night, while all youth were injured during the day (p < 0.01). The primary crash mechanism was a rollover (67%). Only one patient was documented as being helmeted, and approximately one-fourth (24%) sustained head injuries and/or loss of consciousness. Other documented injuries included those to the face (20%), chest (22%), abdomen (11%), extremities (58%), and skin (51%). Over 90% of narratives were consistent with victims being unrestrained. Nearly three-fourths (74%) of victims were hospitalized and 26% required ICU care, ...
    Keywords Recreational off-road vehicles ; Utility task vehicles ; Side-by-sides ; Rollover ; Safety belt ; Harness ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2020-06-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Enforcement of Off-Road Vehicle Laws in Iowa

    Evelyn S. Qin / Gerene M. Denning / Charles A. Jennissen

    Safety, Vol 5, Iss 2, p

    2019  Volume 22

    Abstract: Safety laws are among the most successful means of reducing injuries, but their effectiveness is strongly influenced by the level of enforcement. To characterize enforcement of off-road vehicle (ORV) laws statewide, analyses of citations were performed ... ...

    Abstract Safety laws are among the most successful means of reducing injuries, but their effectiveness is strongly influenced by the level of enforcement. To characterize enforcement of off-road vehicle (ORV) laws statewide, analyses of citations were performed using Iowa Court Information System data. From 2005–2015, 5173 individuals were charged with 5643 citations issued. Citations averaged <5/county/year, decreased dramatically over time, and varied by county when normalized to registered all-terrain vehicles (ATVs). Over 90% of operators cited were male and Caucasian. One-fifth were <18 years old. The top five violations were: operation on a highway/snowmobile trail (51%), registration/identification number not documented/displayed (19%), prohibited use in a park/preserve (5.5%), and operation with more persons than the vehicle is designed to carry (4.4%). The Department of Natural Resources issued the highest percentage of citations, followed in decreasing order by Sheriff, Police, State Patrol, and Conservation officers. Significant differences were identified when citations were compared by sex, age, race, enforcement agency, disposition (guilty vs. not guilty), and when comparing counties with or without an ORV park. These characteristics suggest limited and variable enforcement of laws statewide that may reduce their potential to prevent deaths and injuries, and that improved strategies to support ORV law enforcement are needed.
    Keywords all-terrain vehicle ; off-road vehicle ; injury prevention ; enforcement ; legislation ; Industrial safety. Industrial accident prevention ; T55-55.3 ; Medicine (General) ; R5-920
    Language English
    Publishing date 2019-04-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: The Effect of All-Terrain Vehicle Crash Location on Emergency Medical Services Time Intervals

    Brandon M. Wubben / Gerene M. Denning / Charles A. Jennissen

    Safety, Vol 5, Iss 4, p

    2019  Volume 73

    Abstract: Over 100,000 all-terrain vehicle (ATV)-related injuries are evaluated in U.S. emergency departments each year. In this study, we analyzed the time intervals for emergency medical services (EMS) providers responding to ATV crashes in different location ... ...

    Abstract Over 100,000 all-terrain vehicle (ATV)-related injuries are evaluated in U.S. emergency departments each year. In this study, we analyzed the time intervals for emergency medical services (EMS) providers responding to ATV crashes in different location types. Data from the Iowa State Trauma Registry and a statewide ATV crash/injury database was matched with Iowa EMS Registry records from 2004−2014. Ground ambulance responses to 270 ATV crashes were identified, and response characteristics and time intervals were analyzed. Off-road crashes had a longer median patient access interval ( p < 0.001) and total on scene interval ( p = 0.002) than roadway crashes. Crashes in remote locations had a longer median patient access interval ( p < 0.001) and total on scene interval ( p < 0.001), but also a longer median on scene with patient interval ( p = 0.004) than crashes in accessible locations. Fifteen percent of remote patient access times were >6 min as compared to 3% of accessible crashes ( p = 0.0004). There were no differences in en route to scene or en route to hospital time. Comparisons by location type showed no differences in injury severity score or number of total procedures performed. We concluded that responding EMS providers had an increased length of time to get to the patient after arriving on scene for off-road and remote ATV crashes relative to roadway and accessible location crashes, respectively.
    Keywords all-terrain vehicles ; off-road vehicles ; emergency medical services ; recreational parks ; rural health services ; Industrial safety. Industrial accident prevention ; T55-55.3 ; Medicine (General) ; R5-920
    Subject code 629
    Language English
    Publishing date 2019-10-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Firearm Exposure and Storage Practices in the Homes of Rural Adolescents

    Charles A. Jennissen / Kristel M. Wetjen / Cole C. Wymore / Nicholas R. Stange / Gerene M. Denning / Junlin Liao / Kelly E. Wood

    Western Journal of Emergency Medicine, Vol 22, Iss

    2021  Volume 3

    Abstract: Introduction: Rural areas have higher rates of firearm-related unintentional and suicide deaths. Having access to a firearm greatly increases suicide risk. Safe firearm storage can be a major factor in preventing these tragedies. In this study we ... ...

    Abstract Introduction: Rural areas have higher rates of firearm-related unintentional and suicide deaths. Having access to a firearm greatly increases suicide risk. Safe firearm storage can be a major factor in preventing these tragedies. In this study we evaluated firearm exposure and storage practices in rural adolescents’ homes. Methods: An anonymous survey was administered to a convenience sample of attendees at the 2019 Iowa FFA (formerly Future Farmers of America) Leadership Conference. We performed descriptive, bivariate and multivariable logistic regression analyses. Results: A total of 1,382 adolescents participated; 51% were males and 49% were females. Respondents were 13–18 years old, and 53% lived on a farm, 18% in the country/not on a farm, and 29% in town. Almost all (96%) self-identified as White/Caucasian. In their homes, 84% reported having rifles/shotguns, 58% reported having handguns, and 56% reported having both rifles/shotguns and handguns. Males were significantly more likely than females to report having firearms in their home (P<0.001). The likelihood of having rifles/shotguns was greater if living on a farm (odds ratio (OR) 4.19, 95% confidence interval (CI), 2.99–5.88) or in the country/not a farm (OR 2.74, 95% CI, 1.78–4.24) compared to those in town. Similarly, the presence of handguns in the home was increased if living on a farm compared to in town (OR 1.70, 95% CI 1.32–2.18). Rifles/shotguns and handguns were stored unlocked and/or loaded at least some of the time in 62% and 58% of homes, respectively. Those who lived on farms compared to in towns were more likely to have rifles/shotguns (OR 1.83, 95% CI 1.35–2.46) and handguns (OR 1.58, 95% CI 1.10–2.27) stored unlocked. For homes with unlocked rifles/shotguns, 46% stored ammunition unlocked. For homes with unlocked handguns, 38% stored ammunition unlocked. Among those aware of firearm storage in their home, 82% (802/974) reported at least one firearm stored either unlocked and/or loaded at least some of the time. Conclusion: The vast majority of rural adolescents we surveyed live in homes with firearms, and a large proportion of those firearms are not stored safely. Widespread efforts are needed to educate rural families about the importance of proper firearm and ammunition storage.
    Keywords Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
    Subject code 360
    Language English
    Publishing date 2021-05-01T00:00:00Z
    Publisher eScholarship Publishing, University of California
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Social workers’ determination of when children’s access or potential access to loaded firearms constitutes child neglect

    Charles A. Jennissen / Erin M. Evans / Alycia A. Karsjens / Gerene M. Denning

    Injury Epidemiology, Vol 6, Iss S1, Pp 1-

    2019  Volume 11

    Abstract: Abstract Background Pediatric firearm-related deaths and injuries are a serious societal problem. Our study’s objective was to determine social workers’ assessment of child neglect with respect to access or potential access to a loaded firearm. Methods ... ...

    Abstract Abstract Background Pediatric firearm-related deaths and injuries are a serious societal problem. Our study’s objective was to determine social workers’ assessment of child neglect with respect to access or potential access to a loaded firearm. Methods Study invitations were delivered by e-mail to National Association of Social Workers members designating their practice as “Child/Family Welfare” (N = 4933) in October/November, 2015. Demographics, attitudes regarding child access prevention (CAP) laws, and the ages (4–14 years) at which social workers deemed several scenarios as child neglect were determined. Descriptive (frequencies) and bivariate (chi square) analyses were performed. Results 485 of 4933 social workers completed the survey (9.8%). Of these, most agreed or strongly agreed (≥92%) there should be laws in place requiring firearms to be stored so unwanted access cannot be obtained by a child, even up to 15 years of age. In a scenario where a child had potential access to a loaded firearm, but never gained access, the presence of a CAP law pertinent to the child in the scenario increased the likelihood respondents would find the situation child neglect for all ages (p < 0.0001 for each age comparison). Moreover, 10.3% felt they could not deem the situation child neglect without the presence of a CAP law, no matter the age of the child. In a scenario where a child gained access to a loaded firearm, the vast majority found this to be child neglect (82–99%, with the percentage varying by the age of the child involved), regardless of the presence or absence of a CAP law and/or an injury being sustained. In addition, when a CAP law was in place, social workers were more likely to find neglect if the child had sustained a firearm-related injury as well (p values ranged from 0.016–0.0081 for age comparisons). Conclusions The vast majority of child/family welfare social workers surveyed found it to be child neglect when youth accessed or had potential access to a loaded, unsecured firearm. Results of the ...
    Keywords Firearms ; Child neglect ; Gun storage ; Child access prevention laws ; Suicide ; Social worker ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2019-05-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Rural youth’s exposure to firearm violence and their attitudes regarding firearm safety measures

    Charles A. Jennissen / Ryan P. King / Kristel M. Wetjen / Gerene M. Denning / Cole C. Wymore / Nicholas R. Stange / Pamela J. Hoogerwerf / Junlin Liao / Kelly E. Wood

    Injury Epidemiology, Vol 8, Iss S1, Pp 1-

    2021  Volume 14

    Abstract: Abstract Background In the wake of an epidemic in firearm-related deaths and injuries, youth have become leading voices of concern. This study’s objective was to investigate rural youth’s personal experiences with firearm-related violence, and their ... ...

    Abstract Abstract Background In the wake of an epidemic in firearm-related deaths and injuries, youth have become leading voices of concern. This study’s objective was to investigate rural youth’s personal experiences with firearm-related violence, and their attitudes towards firearms and gun violence prevention strategies. Methods Attendees of the 2019 Iowa FFA Leadership Conference were surveyed about personal experiences with firearm-associated deaths and injuries, and their attitudes regarding firearm-related issues. Descriptive (frequencies), bivariate (chi square, Fisher’s exact test) and multivariable logistic regression analyses were performed utilizing Stata 15.1 (StataCorp, College Station, Texas). Results Responses from 1382 FFA members 13–18 years of age were analyzed. About 5% had personally seen someone threatened with a firearm. Over one-third (36%) stated they knew someone who had been killed or injured by gunfire. Of these, over two-thirds knew of someone who had died or was injured unintentionally and 30% knew of someone killed or injured intentionally (e.g. suicide). Nearly all agreed or strongly agreed that the right to use firearms for hunting and shooting sports should be legal (94%), that a firearm safety course should be required to get a hunting license (89%), and that there should be a required background check before purchasing a firearm (89%). Over three-fifths (61%) agreed or strongly agreed that there should be laws requiring safe storage of firearms in homes. Although still high, lesser support for firearm safety policies was seen among males, older youth, participants living on farms or in the country, and youth who hunted, had firearms in their homes, and/or were in homes with unsafe firearm storage. Conclusions The majority of youth in this study supported firearm safety measures including required training, background checks, and safe firearm storage in homes. These findings are consistent with the national youth-led call for firearm safety. Additionally, over one-third of respondents ...
    Keywords Firearms ; Rifles ; Shotguns ; Handguns ; Youth ; Rural ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2021-09-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Using Geospatial Mapping to Determine the Impact of All-Terrain Vehicle Crashes on Both Rural and Urban Communities

    Evelyn S. Qin / Charles A. Jennissen / Caroline A. Wadman / Gerene M. Denning

    Western Journal of Emergency Medicine, Vol 18, Iss

    2017  Volume 5

    Abstract: Introduction: Deaths and injuries from all-terrain vehicle (ATV) crashes result in approximately 700 deaths each year and more than 100,000 emergency department (ED) visits. Common misconceptions about ATV crashes are a significant barrier to injury ... ...

    Abstract Introduction: Deaths and injuries from all-terrain vehicle (ATV) crashes result in approximately 700 deaths each year and more than 100,000 emergency department (ED) visits. Common misconceptions about ATV crashes are a significant barrier to injury prevention efforts, as is the lack of key information about where and how crashes occur. The purpose of this study was to determine ATV crash patterns within a state, and to compare and contrast characteristics of these crashes as a function of crash-site rurality. Methods: We performed descriptive, comparative, and regression analyses using a statewide off-road vehicle crash and injury database (2002–2013). Comparisons were performed by rurality as defined using the Rural Urban Commuting Area (RUCA) coding system, and we used geographic information system (GIS) software to map crash patterns at the zip code and county levels. Results: ATV crashes occurred throughout the state; 46% occurred in urban and 54% in rural zip code areas. Comparisons of rider and crash characteristics by rurality showed similarities by sex, age, seating position, on vs. off the road, and crash mechanism. Conversely, helmet use was significantly lower among victims of isolated rural crashes as compared to other victims (p=0.004). Crashes in isolated rural and small rural areas accounted for only 39% of all crashes but resulted in 62% of fatalities. In both rural and urban areas, less than one-quarter of roadway injuries were traffic related. Relative crash rates varied by county, and unique patterns were observed for crashes involving youth and roadway riders. During the study period, 10% and 50% of all crashes occurred in 2% and 20% of the state’s counties, respectively. Conclusion: This study suggests that ATV crashes are a public health concern for both rural and urban communities. However, isolated rural ATV crash victims were less likely to be helmeted, and rural victims were over-represented among fatalities. Traffic was not the major factor in roadway crashes in either rural or urban ...
    Keywords Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
    Subject code 360
    Language English
    Publishing date 2017-07-01T00:00:00Z
    Publisher eScholarship Publishing, University of California
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article: Engaging Agribusinesses: Feasibility and Cost of an ATV Safety Poster Project

    Jennissen, Charles A / Shane Sweat / Kristel Wetjen / Pam Hoogerwerf / Gerene M. Denning

    Journal of agromedicine. 2017 Oct. 2, v. 22, no. 4

    2017  

    Abstract: Objectives: All-terrain vehicle (ATV)-related deaths and injuries continue to be a significant problem. Influential change agents such as agribusinesses could be important partners for improving safety behaviors among rural ATV users. Our objective was ... ...

    Abstract Objectives: All-terrain vehicle (ATV)-related deaths and injuries continue to be a significant problem. Influential change agents such as agribusinesses could be important partners for improving safety behaviors among rural ATV users. Our objective was to determine how effectively an injury prevention project could engage agribusinesses through the postal service and to assess their willingness to display a safety poster. Methods: One thousand two hundred forty-four agribusinesses received an ATV safety poster and a postcard survey by mail. A randomized sampling of these businesses was surveyed by telephone 4–7 weeks later. Telephone survey questions included whether they recalled receiving the poster, and if so, whether, where and how long the poster was displayed. Results: One hundred six postcards were returned. Of the 192 eligible business persons contacted by telephone, 89% agreed to participate. Approximately one-third of telephone survey participants recalled receiving the poster. Among these, 81% with walk-in customers posted it, and 74% still had it displayed 1 month later. Of participants who did not recall receiving the poster, 83% stated they would have displayed the poster. The cost of displaying each poster in a business was 16.6 cents/day during the first month. Final costs/day would be much less because of continued display. Conclusion: A high percentage of agribusinesses displayed or would have displayed an ATV safety poster, and most displayed it beyond 1 month. Unfortunately, participant recruitment via postal delivery alone was challenging. Nevertheless, mass mailing of injury prevention materials to be displayed in the retail setting may be a low cost method for raising safety awareness.
    Keywords all-terrain vehicles ; business enterprises ; consumers (people) ; surveys ; telephones
    Language English
    Dates of publication 2017-1002
    Size p. 364-375.
    Publishing place Taylor & Francis
    Document type Article
    ZDB-ID 1289325-0
    ISSN 1545-0813 ; 1059-924X
    ISSN (online) 1545-0813
    ISSN 1059-924X
    DOI 10.1080/1059924X.2017.1358228
    Database NAL-Catalogue (AGRICOLA)

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  9. Article ; Online: Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures

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I Flindall / V Mahendran / J De Marchi / NF Davis / A Picciariello / V Papagni / DF Altomare / S Granieri / C Cotsoglou / A Cabeleira / P Serralheiro / T Teles / C Canhoto / J Simões / AC Almeida / O Nogueira / R Athayde Nemésio / MJ Amaral / A Valente da Costa / R Martins / P Guerreiro / A Ruivo / D Breda / JM Oliveira / AL De Oliveira Lopez / M Colino / J De Barros / AP Soares / H Morais / T Revez / MI Manso / JC Domingues / P Henriques / Cardoso N Ribeiro VI / G Martins dos Santos / M Peralta Ferreira / J Ascensão / B Costeira / L Rio Rodrigues / M Sousa Fernandes / P Azevedo / I Lourenço / G Mendinhos / A Nobre Pinto / H Taflin / H Abdou / L O'Meara / Z Cooper / SA Hirji / BU Okafor / V Roxo / CP Raut / JS Jolissaint / DA Mahvi / C Reinke / S Merola / A Ssentongo / P Ssentongo / Oh JS / J Hazelton / J Maines / N Gusani / RCG Martin / N Bhutiani / R Choron / F Soliman / MD E Dauer / E Renza-Stingone / E Gokcen / E Kropf / H Sufrin / J Sewards / J Poggio / K Sanserino / L Rae / M 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    BMJ Open, Vol 11, Iss

    an international cohort study

    2021  Volume 11

    Keywords Medicine ; R
    Language English
    Publishing date 2021-11-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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

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Bauset / M.K. Abou Chaar / L.M. Marino Cosentino / C.J. Gomez Diaz / J.L. Garcia Galocha / C.A. de Gheldere / G.M. Ataide Gomes / J. Beltran de Heredia / D.G. Blazer III / W.C. Nugent III / A.A. Ali karar / F. Borja De Lacy / J.L. Blas Laina / M.J. Shane Lester / A.S.D. Liyanage / F.S. Al Maadany / J.A. De Marchi / A. Ramos-De la Medina / R.H.M. Mithany / C. Sanchez del Pueblo / G.H. van Ramshorst / M.M. De Salas / A.C. De Souza / M. Dolores Del Toro / J.E. Archer / A. Odeh / S. Erridge / H.K. Salem / G.P. Jones / A. Gardner / S.S. Tripathi / A. Gregg / R. Jeganathan / M.H. Siddique / C.P. Lombardi / B. Martin / C.A. Leo / D. Dass / G. Di Franco / L.R. Jiao / G.M. Mari / L.-. Capitan-Morales / T.M. Connelly / A. Alanbuki / A. De Virgilio / C. Schilling / C. San Miguel Mendez / G. Kulkarni / K. Nizami / S. Walsh / H. Dean / M. Ruiz-Marin / R. Houston / M. Trompetto / D. Chrastek / V. Kouritas / M. Cannoletta / F. Rosato / M.V. Kaushal / P.M. Costa / H.H. Elkadi / J.R. Johnstone / E. Irvine / M.R. Alvarez / C. Corbellini / G.S. Venkatesan / O. Mateo-Sierra / C. Martinez-Perez / J. Serrano Gonzalez / M.A. Hernandez Bartolome / D. Diaz Perez / M. Gutierrez Samaniego / P. Galindo Jara / N. Sharma / N.J. Smart / D.S. Keller

    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 Settore MED/18 - Chirurgia Generale ; covid19
    Language English
    Publisher Lancet Publishing Group
    Publishing country it
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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