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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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- Rebollido, I., et al.
(författare)
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Exocomets: A spectroscopic survey
- 2020
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 639
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Tidskriftsartikel (refereegranskat)abstract
- Context. While exoplanets are now routinely detected, the detection of small bodies in extrasolar systems remains challenging. Since the discovery of sporadic events, which are interpreted to be exocomets (falling evaporating bodies) around β Pic in the early 1980s, only ∼20 stars have been reported to host exocomet-like events. Aims. We aim to expand the sample of known exocomet-host stars, as well as to monitor the hot-gas environment around stars with previously known exocometary activity. Methods. We have obtained high-resolution optical spectra of a heterogeneous sample of 117 main-sequence stars in the spectral type range from B8 to G8. The data were collected in 14 observing campaigns over the course of two years from both hemispheres. We analysed the Ca » II K&H and Na » I D lines in order to search for non-photospheric absorptions that originated in the circumstellar environment and for variable events that could be caused by the outgassing of exocomet-like bodies. Results. We detected non-photospheric absorptions towards 50% of the sample, thus attributing a circumstellar origin to half of the detections (i.e. 26% of the sample). Hot circumstellar gas was detected in the metallic lines inspected via narrow stable absorptions and/or variable blue- and red-shifted absorption events. Such variable events were found in 18 stars in the Ca » II and/or Na » I lines; six of them are reported in the context of this work for the first time. In some cases, the variations we report in the Ca » II K line are similar to those observed in β Pic. While we do not find a significant trend in the age or location of the stars, we do find that the probability of finding CS gas in stars with larger v sin i is higher. We also find a weak trend with the presence of near-infrared excess and with anomalous (λ Boo-like) abundances, but this would require confirmation by expanding the sample.
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