| 3. |
- Khatri, C, et al.
(författare)
-
Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
-
Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
-
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
|
|
| 4. |
- Ibrahim, Mohammed Khaleel, et al.
(författare)
-
3D FE modeling of cable-stayed bridge according to ICE code
- 2022
-
Ingår i: Open Engineering. - : Walter de Gruyter. - 2391-5439. ; 12:1, s. 1126-1133
-
Tidskriftsartikel (refereegranskat)abstract
- This paper presents the performance of a cable-stayed bridge by representing a model using the ANSYS program under the influence of a concentrated load and then comparing the results with the experimental results. One model used in the analysis was the Harp type 1, which used the length of the girder (4500mm), the height of the pylon (1480mm), and the depth of the flange on the girder (40mm). If cable-stayed bridges are constructed using the balanced cantilever method, the stability problem of the girder is more significant during the construction stage than at the initial state. In this study, to investigate the ultimate behavior of cable-stayed bridges, experimental and analytical studies were conducted for one model: Harp Type 1. At the limit state, several plastic hinges occurred, and the girders buckle along the entire span. Numerical analysis was conducted for the experimental model, the results of which showed good agreement with the experimental results. The influence of such effects on the analysis and the structural role of cable-stayed bridges has been detailed and examined in the study. The dimensions of the model were also compared with the ICE Code in terms of the height of the tower to the main space, and the back span to the main span ratio. It was close to standard specifications. A finite element procedure for the nonlinear analysis of cable-stayed bridges first set up and then detailed for the static deflection analysis of such bridges is carried out.
|
|
