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- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 2. |
- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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- Khatri, C, et al.
(författare)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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- Prentice, S. J., et al.
(författare)
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Investigating the properties of stripped-envelope supernovae; what are the implications for their progenitors?
- 2019
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 485:2, s. 1559-1578
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Tidskriftsartikel (refereegranskat)abstract
- We present observations and analysis of 18 stripped-envelope supernovae observed during 2013-2018. This sample consists of five H/He-rich SNe, sixH-poor/He-rich SNe, three narrow lined SNe Ic, and four broad lined SNe Ic. The peak luminosity and characteristic time-scales of the bolometric light curves are calculated, and the light curves modelled to derive Ni-56 and ejecta masses (M-Ni and M-cj). Additionally, the temperature evolution and spectral line velocity curves of each SN are examined. Analysis of the [O I] line in the nebular phase of eight SNe suggests their progenitors had initial masses < 20 M-circle dot. The bolometric light curve properties are examined in combination with those of other SE events from the literature. The resulting data set gives the M-ej distribution for 80 SE-SNe, the largest such sample in the literature to date, and shows that SNe Ib have the lowest median M-ej, followed by narrow-lined SNe Ic, H/He-rich SNe, broad-lined SNe Ic, and finally gamma-ray burst SNe. SNe Ic-6/7 show the largest spread of M-ej ranging from similar to 1.2-11 M-circle dot, considerably greater than any other subtype. For all SE-SNe = 2.8 +/- 1.5 M-circle dot which further strengthens the evidence that SE-SNe arise from low-mass progenitors which are typically <5 M-circle dot at the time of explosion, again suggesting M-ZAMS < 25 M-circle dot. The low and lack of clear bimodality in the distribution implies < 30 M-circle dot progenitors and that envelope stripping via binary interaction is the dominant evolutionary pathway of these SNe.
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