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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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- Orell-Miquel, J., et al.
(författare)
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Confirmation of an He I evaporating atmosphere around the 650-Myr-old sub-Neptune HD 235088 b (TOI-1430 b) with CARMENES
- 2023
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Ingår i: Astronomy and Astrophysics. - 0004-6361 .- 1432-0746. ; 677
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Tidskriftsartikel (refereegranskat)abstract
- HD 235088 (TOI-1430) is a young star known to host a sub-Neptune-sized planet candidate. We validated the planetary nature of HD 235088 b with multiband photometry, refined its planetary parameters, and obtained a new age estimate of the host star, placing it at 600- 800 Myr. Previous spectroscopic observations of a single transit detected an excess absorption of He I coincident in time with the planet candidate transit. Here, we confirm the presence of He I in the atmosphere of HD 235088 b with one transit observed with CARMENES. We also detected hints of variability in the strength of the helium signal, with an absorption of -0.91 ± 0.11%, which is slightly deeper (2γ) than the previous measurement. Furthermore, we simulated the He I signal with a spherically symmetric 1D hydrodynamic model, finding that the upper atmosphere of HD 235088 b escapes hydrodynamically with a significant mass loss rate of (1.5-5) × 1010 g s-1 in a relatively cold outflow, with T = 3125 ±375 K, in the photon-limited escape regime. HD 235088 b (Rp = 2.045 ± 0.075 R⊕) is the smallest planet found to date with a solid atmospheric detection - not just of He I but any other atom or molecule. This positions it a benchmark planet for further analyses of evolving young sub-Neptune atmospheres.
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