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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. |
- Schultes, Lara, et al.
(författare)
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Total Fluorine Measurements in Food Packaging : How Do Current Methods Perform?
- 2019
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Ingår i: Environmental Science and Technology Letters. - : American Chemical Society (ACS). - 2328-8930. ; 6:2, s. 73-78
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Tidskriftsartikel (refereegranskat)abstract
- Per- and polyfluoroalkyl substances (PFASs) represent a class of more than 4000 compounds. Their large number and structural diversity pose a considerable challenge to analytical chemists. Measurement of total fluorine in environmental samples and consumer products is therefore critical for rapidly screening for PFASs and for assessing the fraction of unexplained fluorine(i.e., fluorine mass balance). Here we compare three emerging analytical techniques for total fluorine determination: combustion ion chromatography (CIC), particle-induced gamma-ray emission spectroscopy (PIGE), and instrumental neutron activation analysis (INAA). Application of each method to a certified reference material (CRM), spiked filters, and representative food packaging samples revealed good accuracy and precision. INAA and PIGE had the advantage of being nondestructive, while CIC displayed the lowest detection limits. Inconsistencies between the methods arose due to the high aluminum content in the CRM, which precluded its analysis by INAA, and sample heterogeneity (i.e., coating on the surface of the material), which resulted in higher values from the surface measurement technique PIGE compared to the values from the bulk volume techniques INAA and CIC. Comparing CIC-based extractable organic fluorine to target PFAS measurements of food packaging samples by liquid chromatography-tandem mass spectrometry revealed large amounts of unidentified organic fluorine not captured by compound-specific analysis.
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