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- Glasbey, JC, et al.
(författare)
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- 2021
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swepub:Mat__t
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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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- Subramaniam, R, et al.
(författare)
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Positive and Negative Impacts of COVID-19 in Digital Transformation
- 2021
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Ingår i: SUSTAINABILITY. - : MDPI AG. - 2071-1050. ; 13:16
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This study was designed to research the impact of pandemic situations such as COVID-19 in digital transformation (DT). Our proposed study was designed to research whether COVID-19 is a driver of digital transformation and to look at the three most positive and negative DT disruptors. Our study suggests that COVID-19 is a driver of digital transformation, since 94 percent of respondents agreed that COVID-19 is a driver of DT. The second phase of our study shows that technology, automation, and collaboration (TAC) is the most positive significant factor which enables work from anywhere (WFA) (or work from home) arrangements and also leads to the third positive factor of a work-life balance (WLB). The top three negative factors are no work-life balance (NWL), social employment issues (SEI), and data security and technology issues (DST). The negative factors show a contradictory result since NWL is the most negative factor, even though WLB is the third most positive factor. While the pandemic situation is leading to a positive situation for economies and organizations at a micro level, the negative impacts, which will affect overall economic growth as well as social, health, and wealth wellbeing, need to be kept in mind. The motivation of this study was to research positive and negative effects of COVID-19 on DT, since COVID-19 is impacting everyone and everyday life, including businesses. Our study developed a unique framework to address both positive and negative adoption. Our study also highlights the need for organizations and the economy to establish mitigation plans, as the pandemic has already been disrupting the entire world for the past three quarters.
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