| 4. |
- 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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| 5. |
- Parry, Henry, et al.
(författare)
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The influence of a rocking-motion device built into classic cross-country roller-ski bindings on biomechanical, physiological and performance outcomes
- 2021
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Ingår i: Sports Engineering. - : Springer Nature. - 1369-7072 .- 1460-2687. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to determine whether the recently developed Flow Motion Technology(R) roller-ski prototype could improve indicators of performance during sub-maximal and maximal cross-country roller skiing. Thirteen national and international cross-country skiers completed 2 experimental trials: 1 with Flow Motion Technology(R) activated, allowing a rocking motion between the foot and ski binding, and 1 with the foot fixed in a traditional manner. Each trial included 2 sub-maximal bouts using the diagonal-stride and double-poling sub-techniques, as well as a double-poling maximal velocity test and a diagonal-stride 6-min time trial. There were no differences in performance between Flow Motion Technology(R) and traditional roller skiing during the maximal velocity test or the time trial. However, reductions in mean plantar force during sub-maximal diagonal stride (p = 0.011) and ankle range of motion during sub-maximal (p = 0.010) and maximal (p = 0.041) diagonal stride were observed with Flow Motion Technology(R) versus traditional roller skiing. This, together with a reduced minimum horizontal distance of the hips in front of the ankles during sub-maximal double poling (p = 0.001), indicated impaired technique with Flow Motion Technology(R), which may have contributed to the trend for reduced gross efficiency during double poling with Flow Motion Technology(R) ((p)eta(2) = 0.214). Significant physiological differences included a reduced sub-maximal double poling respiratory exchange ratio (p = 0.03) and a greater maximal heart rate during the time trial (p = 0.014) with Flow Motion Technology(R). We conclude that the application of Flow Motion Technology(R) requires further examination before use in training and competition.
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