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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. |
- Tao, Hai, et al.
(författare)
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Global solar radiation prediction over North Dakota using air temperature : Development of novel hybrid intelligence model
- 2021
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Ingår i: Energy Reports. - Netherland : Elsevier. - 2352-4847. ; 7, s. 136-157
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Tidskriftsartikel (refereegranskat)abstract
- Accurate solar radiation (SR) prediction is one of the essential prerequisites of harvesting solar energy. The current study proposed a novel intelligence model through hybridization of Adaptive Neuro-Fuzzy Inference System (ANFIS) with two metaheuristic optimization algorithms, Salp Swarm Algorithm (SSA) and Grasshopper Optimization Algorithm (GOA) (ANFIS-muSG) for global SR prediction at different locations of North Dakota, USA. The performance of the proposed ANFIS-muSG model was compared with classical ANFIS, ANFIS-GOA, ANFIS-SSA, ANFIS-Grey Wolf Optimizer (ANFIS-GWO), ANFIS-Particle Swarm Optimization (ANFIS-PSO), ANFIS-Genetic Algorithm (ANFIS-GA) and ANFISDragonfly Algorithm (ANFIS-DA). Consistent maximum, mean and minimum air temperature data for nine years (2010–2018) were used to build the models. ANFIS-muSG showed 25.7%–54.8% higher performance accuracy in terms of root mean square error compared to other models at different locations of the study areas. The model developed in this study can be employed for SR prediction from temperature only. The results indicate the potential of hybridization of ANFIS with the metaheuristic optimization algorithms for improvement of prediction ccuracy.
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