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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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| 2. |
- Altamimi, S., et al.
(författare)
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On Stiffness, Strength, Anisotropy, and Buckling of 30 Strut-Based Lattices with Cubic Crystal Structures
- 2022
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Ingår i: Advanced Engineering Materials. - : Wiley. - 1438-1656 .- 1527-2648. ; 24:7
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Tidskriftsartikel (refereegranskat)abstract
- Architected cellular structures are increasingly receiving attention in numerous applications due to advances in additive manufacturing and their promising multi-functional properties. Herein, 30 architected strut-based lattices of cubic crystal symmetry are developed and their stiffness and strength are investigated computationally and experimentally. Finite element simulations are conducted to compute the effective stiffness, yield strength, and buckling strength under uniaxial, shear, and hydrostatic loadings. Also, elastic anisotropy is assessed and bifurcation analysis is performed to estimate the threshold relative density for each lattice. Selected lattices of various relative densities are 3D printed from a polymeric material using selective laser sintering (SLS). The numerical results show that the modes of deformation whether stretching-dominated, bending-dominated, or mixed differ for the various loading conditions. It is observed that by combining different lattice structures in a hybrid approach, a decrease in the anisotropic behavior is obtained, and an overall enhancement of the mechanical properties is achieved. The numerical results show rather good agreement with the experimental findings. The current study can be crucial for using the investigated lattices for enhancing the multi-functional properties of structural systems.
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