38 research outputs found
Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans
No full textnone5200siThe COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19.Nepogodiev D.; Omar O.M.; Glasbey J.C.; Li E.; Simoes J.F.F.; Abbott T.E.F.; Ademuyiwa A.O.; Biccard B.M.; Chaudhry D.; Davidson G.H.; Di Saverio S.; Gallo G.; Ghosh D.; Harrison E.M.; Hutchinson P.J.; Kamarajah S.K.; Keller D.S.; Lawani I.; Minaya-Bravo A.; Moore R.; Morton D.G.; Ntirenganya F.; Pata F.; Pearse R.M.; la Medina A.R.-D.; Tabiri S.; Venn M.L.; Omar A.B.O.M.; Bhangu A.; Harrison E.M.; Siaw-Acheampong K.; Adamina M.; Agarwal A.; Alameer E.; Alderson D.; Alakaloko F.; Alser O.; Arnaud A.P.; Augestad K.M.; Bankhead-Kendall B.K.; Barlow E.; Benson R.A.; Blanco-Colino R.; Brar A.; Minaya-Bravo A.; Breen K.A.; Buarque I.L.; Caruana E.J.; Chakrabortee S.; Cox D.; Cunha M.F.; Dawson B.E.; Desai A.; Drake T.D.; Edwards J.G.; Elhadi M.; Evans J.P.; Farik S.; Fiore M.; Fitzgerald J.E.; Ford S.; Ghosh D.; Gomes G.M.A.; Griffiths E.A.; Gujjuri R.R.; Halkias C.; Heritage E.; Isik A.; Jenkinson M.D.; Jones C.S.; Khatri C.; Keatley J.M.; Kolias A.; Lawday S.; Lederhuber H.; Leventoglu S.; LAffler M.W.; Martin J.; Mashbari H.N.; Mazingi D.; Mckay S.C.; Metallidis S.; Mohan H.M.; Moszkowicz D.; Moug S.; Ng-Kamstra J.S.; Niquen M.; Outani O.; Pellino G.; Pinkney T.D.; Pockney P.; Radenkovic D.; Roberts K.; Roslani A.C.; Santos I.; Schache A.; Schnitzbauer A.A.; Stewart G.D.; Shaw R.; Shu S.; Soreide K.; Spinelli A.; Sundar S.; Tiwari A.; Townend P.; Trout I.M.; Tsoulfas G.; van Ramshorst G.H.; Vidya R.; Vimalachandran D.; Warren O.; Wilkin R.J.W.; Wright N.; Hoste E.; Huyghens L.; Jacobs R.; Opdenacker G.; Poelaert J.; Rijckaert D.; De Decker K.; Foubert L.; De Neve N.; Biston P.; Piagnerelli M.; Collin V.; den Blauwen N.; Clauwaert C.; De Crop L.; Hoste E.; Verbeke A.; Derumeaux P.; Gardin C.; Kindt S.; Louage S.; Verhamme B.; DruwACopyright P.; Lahaye I.; Rosseel F.; Rutsaert R.; Vanlinthout L.; De Kock M.; Forget P.; Kahn D.; Lois F.; Momeni M.; Yemnga A.P.B.; Jadoul J.-L.; Malbrain M.; Bosinceanu D.; Collard E.; Jorens P.; Reyntiens D.; Smitz C.; Vercauteren M.; Fagnoul D.; Toplice K.; OremuA¡ K.; BeA¡lic G.; Duzel V.; Hauptman A.; Peremin S.; Aribar A.; A½upcic M.; Brod S.; Mirkovic I.; Bauer Z.A.; Belavic M.; BlaA¾anin B.; KatuA¡in M.L.; Krijan A.B.; MiA¡kovic P.; Aimic-Korac N.; Topic J.; A½ilic A.; A½unic J.; Acan I.; Adanic M.; Ivanov N.; Aaric J.P.; Tomulic K.; Viskovic N.; BoA¡njak S.; Drenjancevic I.H.; Kristek G.; Kvolik S.; Markic S.; Rakipovic A.S.; Tot O.K.; Fabris L.K.; Bacak-Kocman I.; Balenovic I.; Bandic D.; Deutsch P.A.J.; Divjak L.; Filipovic I.G.; GuA¾vinec Z.; Krznaric Z.; Loncaric Y.; MagaA¡ J.V.; Mitrovic M.; Okic M.; Pavlek M.; Ramov E.; Rezek K.; Sekulic A.; Tomasevic B.; Miric M.; TomaA¡evic A.; Mahecic T.T.; Vrbanovic V.; Bobinac M.; BoA¾ic A.; Debelic D.; Frkovic V.; Batinica I.M.; Baranovic S.; Gavranovic A½.; Kikec M.; Maldini B.; Maric S.; Agnic I.; Delic N.; Dropulic N.; GaA¡pic T.K.; Ilic D.; Ivancev B.; Karanovic N.; KuA¡cevic D.; Marovic Z.; Milic M.; NeveA¡canin A.; Petkovic T.; Smoje M.; Brozovic G.; Goranovic T.; Jelisavac M.; Matolic M.; Mazul-Sunko B.; Oberhofer D.; Pavicic A.M.; Aakic K.; Bozovic M.D.; Krecek Z.K.; Krobot R.; Andabaka T.; Bratanic M.; Dzepina O.; Kraljev M.; Aeric J.; Aimurina T.; Grujic R.; Nacevski-Bulaja B.; BariA¾on M.; Danira V.; DraA¾en B.; DuA¡anka K.; HaluA¾an M.B.; JoA¡ko A½.; Katica R.; Labor M.; Marinkovic T.G.; Mihovilcevic D.; Marija B.; Srecko M.; Drab M.; Hudacek K.; Krikava I.; Stourac P.; BrabcovA¡ M.; KlozovA¡ R.; Vajter J.; Vymazal T.; Toft P.; Blichfeldt L.; Hansen B.D.; Moller K.; Nielsen J.S.; Frederiksen J.; Andersen J.D.; KA¼hne J.P.; Leivdal S.; Stendell L.; Simonsen M.; Zoltowski M.K.; Ali Z.S.; Freundlich M.; Pilypaite J.; Clausen N.G.; Toft P.; Thorup L.; Hansen F.; Bestle M.; Hansen C.S.; Afshari A.; Bille A.B.; Lefort M.; Secher E.L.; Liboriussen L.; Herodes V.; HA¤rma E.; Marvet K.; Pool K.; Kallas P.; MA¤gi T.-K.; SA¼tt J.; Vijar K.; Visk E.; Vinnal M.; Ellermaa J.; Liibusk L.; Hovilehto S.; Kirsi A.; Mustola S.; Tiainen P.; Toivonen J.; Dabnell S.; Kaminski T.; Sysimetsa A.; Kaukonen M.; Silvasti P.; Vainio K.; Lund V.; SjAvall S.; Saarinen K.; Viitanen M.; Ahonen T.; AlaspA¤A¤ A.; Zittling R.; Saarinen A.; Moisander A.; Wagner B.; Laru-Sompa R.; Elomaa E.; Lavonen L.; Nevantaus J.; Geier K.; Kavasmaa T.; Koorits U.; Kubjas M.; Lauritsalo S.; Ottelin L.; Palve M.; PynnAnen J.; RA¤A¤bis I.; Saarelainen M.; HeikkilA¤ T.; Kontula T.; LehtimA¤ki M.; Liimatainen J.; Moilanen-Oikarinen M.; Pakarinen M.; Palanne R.; SeppA¤nen H.; Pulkkinen A.; VA¤A¤rA¤niemi H.; Kajaani; Paananen S.; Koskenkari J.; SA¤lkiA S.; Vakkala M.; Koskue T.; Loisa P.; Laitio R.; HautamA¤ki R.; Koivisto S.-P.; Leon A.; Bonnet F.; Marret E.; Spielvogel C.; Papageorgiou C.; Szymkiewicz O.; Tounou-Akue F.; Aubrun F.; Bonnet A.; Gazon M.; Guiraud M.; Laurent V.; Tachon G.; Demars N.; Dumenil A.-S.; Mercier F.J.; Landais A.; Mentec H.; Bazin M.; Futier E.; Gonnu S.; Petit A.; Albaladejo P.; Almeras L.; Rossi-Blancher A.B.M.; Lefrant J.Y.; Barthel F.; Hallel D.; Sbai H.; Khalifeh P.; Lidzborski L.; Jully M.; Platon E.; Pottecher J.; Baumgarten R.; Schultz C.; ElMiloudi F.; Lefebvre J.; Waton K.; Sprunck A.; Steib A.; Thibaud A.; Thuet V.; Kieffer V.; Dubois-Vallaud D.; Jacob L.; Becanne X.; Cherfaoui S.; Gauzit R.; Godier A.; Lakhdari M.; Samma C.M.; Halchini C.; Lacroix M.; Pinna F.; Barbes A.; Just B.; Mateu P.; Benayoun L.; Berger P.; Granier N.; Perrigault P.F.; Libert N.; De Rudnicki S.; Merat S.; Bourdet B.; FerrACopyright F.; Minville V.; Piriou V.; Rague P.; Wallet F.; Lebuffe G.; Desbordes J.; Robin E.; Ichai C.; Orban J.-C.; Gottschalk A.; Piontek A.; Unterberg M.; Hilpert J.; Kees M.; Triltsch A.; Wiegand-LAhnert C.; GlAckner C.; Hohn A.; Rose E.; SchrAder S.; Wiese O.; Awlakpui E.; Hoeft A.; Scheidemann M.; Wittmann M.; Ramminger A.; Dresden C.; de Abreu M.G.; Heller A.R.; Marx C.; Neidel J.; Goldmann A.; von Heymann C.; Laetsch B.; Maahs E.; Scholz L.; Frenzel D.; Massarat K.; Lenhart F.-P.; Reichle F.; Rudlof K.; Borchers F.; Buettner C.; Schmutzler M.; Lucht A.; Wagner J.; Wuppertal H.K.; Pilge S.; Schneider G.; Untergehrer G.; Bis B.; Krassler J.; Dittmann J.; Haberkorn J.; Eberitsch J.; Eberitsch K.; Nippraschk T.; Wepler U.; Engelen W.-C.; Nau C.; Scholler A.; SchA¼ttler J.; Wintzheimer S.; Bloos F.; Braune A.; Fergen D.; Ludewig K.; Paxian M.; Reinhart K.; Graf N.; Schwarzkopf K.; Berger K.; Habicher M.; Kasperiunaite R.; Savelsberg S.; Krep H.; Reindl M.; Bauer W.; Bingold F.; Christ S.; Friederich P.; Kaviani R.; Auer P.; BonnlA¤nder G.; Drescher J.; Braun R.; Eichenauer T.; Kerner J.; Bierbaum K.; BrA¼nner H.; Grond S.; Perez-Platz U.; Andresen B.; Linstedt U.; Stegmann N.; Erkens U.; Kopcke J.; Meyer A.; Brestrich H.; Ernst S.; Merkel S.; Krieger L.; Luers F.; Weyland A.; Noeldge-Schomburg G.; Wasmund C.; Bredtmann R.-D.; Erler I.; Haumann C.; MAllemann A.; Oehmichen U.; Sergejewa O.; Lehning B.; Czeslick E.; Geyer M.; Malcharek M.; Sablotzki A.; Stier M.; Feld F.; Marx G.; Rossaint R.; Simon V.; Armaganidis A.; Kotanidou A.; Nanas S.; Papastylianou A.; Psevdi A.; Stathopoulos A.; Voulas A.; Kanna E.; Koutsikou A.; Moustaka A.; Chovas A.; Komnos A.; Zafiridis T.; Franses J.; Lavrentieva A.; Koraki E.; Katsenos C.; Kasianidou M.F.; Nasopoulou P.; Spyropoulou E.; Gousia C.; Katsanoulas C.; Lathyris D.; Kyriazopoulos G.; Sfyras D.; Tsirogianni A.; Kostopanagiotou G.; Koulenti D.; Lignos M.; Matsota P.; Christopoulos C.; Mouratidou A.; Vrettou E.; Boufidis S.; Moka E.; Arnaoutoglou E.; Koulouras V.; Nakos G.; Papathanakos G.; Anthopoulos G.; Choutas G.; Karapanos D.; Tzani V.; Gkiokas G.; Nastos K.; Nikolakopoulos F.; Dragoumanis C.; Nikitidis N.; Pneumatikos I.; Theodorou V.; Zacharouli D.; Kandi S.; Tasopoulos K.; Arvaniti K.; Matamis D.; Mplougoura E.; Petropoulou P.; Soumpasis I.; Amaniti E.; Giannakou-Peftoulidou M.; Gkeka E.; Soultati I.; Kokinou M.; Papatheodorou L.; Stafylaraki M.; Giasnetsova T.; Gritsi-Gerogianni N.; Kydona C.; Kiskira O.; Koulentis I.; Apsokardos A.; Dimitropoulos K.; Soldatou O.; Nathanail C.; Papazotos A.; Tsakas P.; Clouva-Molyvdas P.-M.; Kolotoura A.; Sartzi M.; Papanikolaou S.; Polakis P.; Karatzas S.; Kyparissi A.; Papavasilopoulou T.; Koukoubani T.; Mastora E.; Nyktari V.; Malliotakis P.; Papaioannou A.; Bekos V.; Maragkou E.; Spring A.; Ioakeimidou S.E.A.; Noulas N.; MolnA¡r Z.; CsA¼llAg E.; Elekes E.; MolnA¡r T.; Katona Z.; Kremer I.; Miko A.; Budapest; Csomos A.; Galambos Z.; Szucs A.; Szekeres G.; Szabo E.; Kranitz K.; Simon M.; Szigeti J.; GaA¡l E.; Havas A.; Ille A.; Miskolc; BrA¡z K.; Nagy G.; Hafeez P.; Hanumanthaiah D.; Brohan J.; O'Chroinin D.; Bailey K.; Ramamoorthy K.G.; Doyle Y.; Freir N.; O'Rourke J.; Jonson P.; Saeed S.; Hayes I.; Loughrey J.; Frohlich S.; McCauley N.; Ryan D.; Fitzpatrick G.; Kevin L.; Thomas J.; Warde B.; Woolhead A.; Duggan M.; Egan C.; Crowley S.; Lebese S.; Bergin A.; Westbrook A.; Page R.; Collins D.; McKenny M.; Bresciani A.; Carmino L.; Ghelfi S.; Lorenzelli L.; Novelli M.T.; Pescarmona C.; Roasio A.; Gatta A.; Nastasi M.; Sanseverino M.; Tinti C.; Bianchin A.; Tormena M.P.; Franco A.; Marini F.; Di Mauro P.; Rapido F.; Tommasino C.; Bellotti F.; Boninsegna D.; Castellani G.; Sances D.; Spano G.; Tredici S.; Vezzoli D.; Fucecchio I.; Bacci A.; Coppini R.; Dell'unto S.; Mori E.; Stanzani M.R.; Tosi M.; Collareta M.; Forfori F.; Franchi M.; Mancino G.; Battistella M.; Baricocchi E.; Bona F.; Debernardi F.; Giacoletto G.; Iacobellis A.; Massucco P.; Moselli N.; Muratore A.; Palomba G.; Sardo E.; Suita L.; Zocca E.; Bucci B.; Corte F.D.; Piciucco T.; Viarengo V.; Cantarini E.; Giampieri M.; Tanfani A.; Recchia E.; Bignami E.; Bruno G.; Costagliola R.; Gandolfi A.; Greco M.; Lembo R.; Monti G.; Nicelli E.; Pasculli N.; Turi S.; Rocca G.D.; Baroselli A.; Brazzoni M.; Buttazzoni M.; Buttera S.; Centonze C.; Serena G.; Spagnesi L.; Toretti I.; Vilardi A.; Zearo E.; Arpino I.; Baraldi S.; Guarnerio C.; Molene V.; Monea M.C.; Vaccarisi E.; Vicari L.; Albante A.; Aversano M.; Loiacono C.; Marandola M.; Fusari M.; Petrucci N.; Galla A.; Mascia A.; Primieri P.; Di Noto A.; Gratarola A.; Molin A.; Pelosi P.; Spagnolo L.; Spena C.; Calligaro P.; Marchiotto S.; Merlini A.; Pedrazzoli E.; Perina G.; Visentin R.; Fumagalli R.; Garbagnati A.; Manetti B.; Snaier C.; Somaini M.; Farnia A.; Nani R.; Pierantonio N.; Grasso S.; Gazzanelli S.; Marandola M.; Pugliese F.; Ruberto F.; Bergamini E.; Tassinati T.; Capuzzo M.; Cirillo V.; Tufano R.; Oggioni R.; Parrini V.; Brunori E.; Capone M.; Carbone L.; Corradetti F.; Elisei D.; Fiorentino S.; Francesconi M.; Gattari D.; Gorgoglione M.; Iacobone E.; Minnucci F.; Montironi C.; Riccioni G.; Tappata G.; Zompanti V.; Verdenelli P.; Cerutti E.; Ranieri V.M.; Grigorjevs S.; Rikmane M.; Rozkalne D.; Stepanovs J.; Suba O.; Golubovska I.; Kazune S.; Miscuk A.; Nemme J.; Oss P.; Sipylaite J.; Macas A.; Ragaisis V.; Kontrimaviciute E.; Tomkute G.; Boerma E.C.; Leeuwarden M.C.; Kramer I.F.; Poeze M.; Maria J.; Pelzer G.; Nijsten M.; Schoorl M.; Spanjersberg R.; Buhre W.; Dieleman S.; van Klei W.A.; Bouw M.; Pickkers P.; Schreiner F.; Zandvliet R.; van den Berg R.; De Wit E.; Keijzer C.; Hollmann M.W.; Preckel B.; van Acker G.J.D.; Dennesen P.J.W.; Kuijpers-Visser A.G.; Inan T.; Gemert A.W.M.M.K.-V.; Ponssen H.H.; Brouwer T.; Koopmans M.; van Bommel J.; van Duijn D.; van der Hoven B.; Ormskerk P.; Beck O.; Schiere S.; Reidinga A.C.; Venema A.; Jammer I.; Dokka V.; Monsen S.A.; Ytrebo L.M.; Noursadeghi M.; Shahzad A.; Boksasp O.D.; Roiss C.; Strietzel H.F.; Berntsen A.G.S.; Haugland H.; Vingsnes S.O.; Axelsson P.; Risom Olsen T.C.; Katre S.; Aakeroey K.; Tamowicz B.; Bozilow D.; Goch R.; Grabowski P.; Kupisiak J.; Mallek M.; Szyca R.; Kostyrka W.; Choma R.; Jankowski G.; Koscielniak W.; Pietraszek P.; Szarowar B.; FranA§a C.; Lacerda A.P.; Ormonde L.; Rosa R.; Pereira I.; Vitor P.; Bento H.C.; Carvalho M.R.L.M.; Faria M.; Almeida E.; Mealha R.; Vicente R.; Monte R.; Rua F.; Barros N.; Esteves F.; Pinheiro C.M.G.; Real V.; Oliveira V.M.; Oliveira M.F.; Martins I.; Saraiva J.P.; AssunA§A£o J.P.; BA¡rtolo A.; Carvalho A.; Correia C.; Martins S.; Milheiro R.; Diaz A.; GonA§alves M.I.; Ribeiro R.; Estilita J.; GlAria C.; de Almeida J.; Barros F.; Ramos A.; Camara M.; Maul E.R.; Nobrega J.; Langner A.; Maia D.F.; Afonso O.; Faria F.; Serra S.; Botelho M.M.; Ferreira P.; MourA£o L.; Oliveira A.V.; Resende M.; Aleman M.; Fonseca J.; Isidoro M.; de Meneses H.; PAªgas A.; Pereira J.; Pereira L.; Ramos B.; Matos F.; Matos R.; de Lurdes GonA§alves Castro M.; Martins A.; Ramos C.; de Sousa M.; Bento L.; Botas C.; Lopes V.; Mendes R.; Blaj M.; Damian M.; Lupusoru A.; Ristescu I.; Codreanu M.; Diaconescu C.; Nistor A.; Stelian D.S.; Streanga L.; Berneanu M.; Bordeianu C.; Florenta C.; Iacob A.; Lupu M.N.; Mocanu I.; Moraru C.; Meran C.; Nicolae B.; Sandu M.; Turcanu R.; Epure F.; Grigore M.; Hotaranu C.; Popescu N.; Baban O.; Baciu M.; Ciobanu A.; Maftei I.; Moldovan I.; Ungureanu L.; Bogdan P.; Corneci D.; Dinu M.; Madalina D.; Rely M.; Silvius N.; Tomescu D.; Gabriela D.; Dinescu S.A.; Calin M.; Ionescu D.; Margarit S.; Vasian H.; Albu C.; Balasa C.; Cadrigati A.; Dragulescu D.; Gavra L.; Hentia C.; Macarie C.; Manescu M.; Nediglea I.; Ocica D.; Ovidiu B.; Papurica M.; Plavat C.; Popa C.; Ramneantu M.; Sandesc D.; Sandici Z.; Sarandan M.; Belciu I.; Tincu E.; Aignatoaie M.; Huzuneanu M.; Cocu S.; Hagau N.; Ciubotaru R.; Copotoiu S.-M.; Copotoiu R.; Ioana G.; Kovacs J.; Leonard A.; Szederjesi I.; Genoveva V.; Mosnegutu S.; Djordjevic D.; Djordjevic B.; Grujic K.; Jovanovic D.; Obradovic J.; Zeba S.; Jevdjic J.; Miletic M.; Zunic F.; Bulasevic A.; Brko R.; Gazibegovic N.; Kendrisic M.; Vojinovic R.; CapkovA¡ J.; Firment J.; Grochova M.; Trenkler S.; Griger M.; Zahorec R.; Bakosova E.; Kvasnica M.; Saniova B.; Sulaj M.; Zacharovska A.; Simkova A.; CAkovA¡ A.; Gebhardtova A.; HanuljakovA¡ S.; Koutun J.; MartonovA¡ A.; A½ilincA¡rovA¡ V.; Galkova K.; Krbila S.; Sobona V.; Ocenasova M.; Novak-Jankovic V.; Stecher A.; Stivan F.; Grynyuk A.; Damjanovska M.; Kostadinov I.; Knezevic M.; Malivojevic M.; Borovsak Z.; Kamenik M.; MekiA¡ D.; KapA¡ S.O.; Aleksic D.; Gerjevic B.; Kalan K.; Ursic T.; Artigas A.; Garcia A.; Lisi A.; Perez I.; Perez G.; Poch N.; Vaquer S.; Balciscueta G.; Barrasa H.; Cabanes S.; Maynar J.; Poveda Y.; Rodero A.Q.; Vallejo A.; Duque P.; Garcia-Bunger B.; Elvira M.A.; Lajara A.M.; Palencia M.; Ramos R.; Fernandez A.S.; LeAn J.P.T.; LApez J.I.; Murillo F.J.Y.; Ramirez E.T.; Rico P.U.; Patricia M.; VizcaAno M.; Alvarez M.J.B.; Real K.P.; Serra A.M.; Aracil N.; Bodega B.M.; GarcAa R.F.; GarcAa M.A.; de la Quintana Gordon B.; JodrA¡ A.G.; LApez A.D.S.; Ros J.J.L.; Soto R.A.; SepAºlveda I.; DAez E.P.; FernA¡ndez L.F.; Gulina C.S.; Arviza L.P.; Fernandez L.M.; GAmez A.R.; MartAnez C.A.; RodrAguez A.B.R.; Soto C.L.; Aldecoa C.; Garcia C.; Lorenzo M.; Pinilla E.; Rico J.; Ruperez I.; Alonso E.; Leira F.; Maseda D.P.E.; Royo C.; Villagran J.; Candi G.M.; Esteva G.E.; Folgado R.M.; Fornaguera N.J.; Montse P.C.; Prat A.S.; Sintes D.; Arteta D.A.; Delgado H.G.; LApez-Cuervo J.F.; LApez M.C.; RamArez A.; SaldaA+/-a F.J.; Aliste P.; Anchuelo A.H.; Campos A.G.; CatalA¡n M.; GAmez M.G.; Gonzalaez O.G.; LApez E.L.; Navacerrada I.R.; de Quevedo S.A.; Serrano M.G.; Silvestre F.P.-C.; Torrente F.M.; Arocas B.; Martinez E.P.; Soro M.; Maroto F.; Algarra R.R.; Aleixandre I.S.; Argente G.R.; LleA A.B.; Rubio A.V.; SA¡nchez J.L.V.; ValcA¡rcel I.E.; Balust C.; Balust J.; Borrat X.; Carretero M.J.; Gracia I.; Matute P.; Mercadal J.; Pujol R.; Tena B.; Ubre M.; Albalad D.D.; Alcaide C.M.; Caballero J.; Cervantes A.C.; de Nadal Clanchet M.; Estruch N.M.; Ferrer M.B.; Fornells A.L.; Galera E.T.; Martinez I.G.; MuA+/-oz S.M.; Pelavski A.; Perez P.T.; Posada M.A.G.; de Prat I.C.; Rello J.; Serrano L.G.; Sieiro J.M.N.; Silva L.; Sole M.J.C.; SuA+/-ACopyright A.B.; Villach I.R.; Herreras J.I.G.; Poves R.; Rafael B.M.; Almeida I.M.; Collates A.F.; BartolomACopyright M.J.; Cimadevilla B.; GonzA¡lez A.M.G.; Llevot J.M.R.; de TerA¡n Mira J.C.D.; Molina B.G.; Pardo S.; SA¡nchez C.L.; Williams M.; Zaldibar E.; Corsini L.M.; Fraile J.R.R.; de la Lastra M.; Sacramento M.K.; SaA+/-a F.J.L.; Alvarez J.T.; Bulnes M.L.C.; Carrasco V.G.; del RocAo MAguez Crespo M.; Cubillos D.N.; Laza E.L.; del Pino Heredia PACopyrightrez M.; Seisdedos A.A.; Torres B.F.; Ampuero M.S.; Llano M.C.; Mata E.; Munoz M.; Orts M.; Planas A.; Ramasco F.; Roman C.; DurA¡n M.V.; del RAo Fernandez S.; Otero Y.S.; Pineiro S.L.; Pardal C.B.; Alcantud J.F.; Antolinos M.A.; Barrios F.; Casanova A.C.; Castro M.R.; Crespo B.I.; Felipe U.L.; Fuster M.L.; GarcAa M.S.; Garrote B.H.; Gonzalez R.M.; Granero M.J.M.; de la GuAa C.L.; LApez R.C.; de Frutos LApez S.; Martinez J.J.M.; Mostaza A.G.; Moreno A.J.; Osado I.R.; PACopyrightrez M.R.; PiA+/-a M.A.; Romero C.A.; RodrAguez E.R.; Salvan J.H.; Sampedro M.G.; de la Torre P.A.; Toro J.P.; UnzAºe C.L.; Vargas M.J.; Bernal D.G.; Echevarria M.; Iglesias A.U.; Loza A.; Morillo A.R.; Serrano P.D.; Sevilla F.C.B.; Cacho E.; CalderAn R.; Dufur M.; Marginet C.; Monedero P.; Yepes M.J.; Alvarez L.R.; Carballal F.F.; CastiA+/-eiras A.P.; GarcAa P.D.; LApez L.R.; Maceiras P.R.; Puente M.S.M.; Rilo M.T.R.; Alonso A.E.T.; FernA¡ndez S.R.; GarcAa R.O.; GarcAa A.P.; Puentes R.B.; Aguado D.N.; Carballo C.L.; Fernandez R.F.; Presedo A.T.; de Rabago R.B.D.; Velasco A.R.; Capel Y.J.; CortACopyrights A.F.; GarcAa E.M.; Gimeno L.M.; Klamburg J.; Omedas R.C.; NAºA+/-ez M.G.; Maristany C.L.; Ruiz E.M.; Artigas X.; CastrillAn S.; Espinosa N.; Gomez-Caro A.M.; Illa S.; India I.; MartAn-Huerta B.; Moral V.; Moreno M.; FernA¡ndez C.I.; GarcAa V.F.; HernA¡ndez P.P.; Checa A.A.H.; Diaz D.S.; Noguera M.L.; Varela I.P.; GonzA¡lez Gallego M.A.; GarcAa O.M.; Irujo J.J.A.; Perrino C.G.; Picazo J.R.; Timoneda F.L.; Arroyo M.M.; Blanco I.A.; Borja M.M.; Burcio S.M.; Castro N.M.; CerdeiriA+/-a A.P.; de la Torre Concostrina M.; Cristina M.V.; DAaz T.D.; Esteruelas J.A.; Ingelmo I.I.; Insuga P.D.; Llamas E.C.; Lopez J.J.M.; MartAn M.B.; MartAn E.E.; Mesa E.U.; Monterde M.L.; Montoiro P.A.; MAstoles M.L.G.; Olarte E.V.; PACopyrightrez A.M.; Perez F.D.; Romero A.S.; Rous D.P.; Ruiz N.M.; Ruiz J.A.P.; Saiz A.R.; de la Vega Terol A.; Toha A.C.; Utrera F.A.; Alberdi F.; ElAsegui I.; GarcAa J.; Garde P.M.; Mintegui E.I.; SA¡ez I.G.; Salas E.; Zabarte M.; Diaz-Boladeras R.-M.; Mora-Guevara E.; Zamora J.F.; Bonet A.; Salo L.; Salinas U.; Zaballos J.M.; Alvarez A.A.; Garrido C.J.; Roa J.R.H.; Vidal F.G.; Garcia-Egea J.; Elson M.Z.; Seron-Arbeloa C.; Asensio M.A.M.; SimeAn R.G.; Alameda L.E.M.; Angulo G.O.; Aranzubia M.; Arcas J.J.; Arevalo J.; Belvert B.Q.; Calvo C.P.; Cremades M.; Crespo P.; Cuarental A.; Del Olmo M.; FernA¡ndez P.T.; Vega J.L.F.G.I.G.; Herrera E.; Llorente M.A.A.; Rabes C.M.; de Maeyer A.G.; Marquez M.P.; Mendoza D.L.; MuA+/-oz J.M.M.; MartAnez N.A.; Oviedo A.S.; Garrigues P.B.; Inigo J.A.; Ferrandiz S.T.; 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Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans
No full textnone5200siBackground: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. Methods: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. Results: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. Conclusion: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely.mixedNepogodiev D.; Omar O.M.; Glasbey J.C.; Li E.; Simoes J.F.F.; Abbott T.E.F.; Ademuyiwa A.O.; Biccard B.M.; Chaudhry D.; Davidson G.H.; Di Saverio S.; Gallo G.; Ghosh D.; Harrison E.M.; Hutchinson P.J.; Kamarajah S.K.; Keller D.S.; Lawani I.; Minaya-Bravo A.; Moore R.; Morton D.G.; Ntirenganya F.; Pata F.; Pearse R.M.; la Medina A.R.-D.; Tabiri S.; Venn M.L.; Omar A.B.O.M.; Nepogodiev D.; Bhangu A.; Harrison E.M.; Siaw-Acheampong K.; Adamina M.; Agarwal A.; Alameer E.; Alderson D.; Alakaloko F.; Alser O.; Arnaud A.P.; Augestad K.M.; Bankhead-Kendall B.K.; Barlow E.; Benson R.A.; Blanco-Colino R.; Brar A.; Minaya-Bravo A.; Breen K.A.; Buarque I.L.; Caruana E.J.; Chakrabortee S.; Cox D.; Cunha M.F.; Dawson B.E.; Desai A.; Drake T.D.; Edwards J.G.; Elhadi M.; Evans J.P.; Farik S.; Fiore M.; Fitzgerald J.E.; Ford S.; Ghosh D.; Gomes G.M.A.; 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Martonova A.; Zilincarova V.; Galkova K.; Krbila S.; Sobona V.; Ocenasova M.; Novak-Jankovic V.; Stecher A.; Stivan F.; Grynyuk A.; Damjanovska M.; Kostadinov I.; Knezevic M.; Malivojevic M.; Borovsak Z.; Kamenik M.; Mekis D.; Kaps S.O.; Aleksic D.; Gerjevic B.; Kalan K.; Ursic T.; Artigas A.; Garcia A.; Lisi A.; Perez I.; Perez G.; Poch N.; Vaquer S.; Balciscueta G.; Barrasa H.; Cabanes S.; Maynar J.; Poveda Y.; Rodero A.Q.; Vallejo A.; Duque P.; Garcia-Bunger B.; Elvira M.A.; Lajara A.M.; Palencia M.; Ramos R.; Fernandez A.S.; Leon J.P.T.; Lopez J.I.; Murillo F.J.Y.; Ramirez E.T.; Rico P.U.; Patricia M.; Vizcaino M.; Alvarez M.J.B.; Real K.P.; Serra A.M.; Aracil N.; Bodega B.M.; Garcia R.F.; Garcia M.A.; de la Quintana Gordon B.; Jodra A.G.; Lopez A.D.S.; Ros J.J.L.; Soto R.A.; Sepulveda I.; Diez E.P.; Fernandez L.F.; Gulina C.S.; Arviza L.P.; Fernandez L.M.; Gomez A.R.; Martinez C.A.; Rodriguez A.B.R.; Soto C.L.; Aldecoa C.; Garcia C.; Lorenzo M.; Pinilla E.; Rico J.; Ruperez I.; Alonso E.; Leira F.; Maseda D.P.E.; Royo C.; Villagran J.; Candi G.M.; Esteva G.E.; Folgado R.M.; Fornaguera N.J.; Montse P.C.; Prat A.S.; Sintes D.; Arteta D.A.; Delgado H.G.; Lopez-Cuervo J.F.; Lopez M.C.; Ramirez A.; Saldana F.J.; Aliste P.; Anchuelo A.H.; Campos A.G.; Catalan M.; Gomez M.G.; Gonzalaez O.G.; Lopez E.L.; Navacerrada I.R.; de Quevedo S.A.; Serrano M.G.; Silvestre F.P.-C.; Torrente F.M.; Arocas B.; Martinez E.P.; Soro M.; Maroto F.; Algarra R.R.; Aleixandre I.S.; Argente G.R.; Lleo A.B.; Rubio A.V.; Sanchez J.L.V.; Valcarcel I.E.; Balust C.; Balust J.; Borrat X.; Carretero M.J.; Gracia I.; Matute P.; Mercadal J.; Pujol R.; Tena B.; Ubre M.; Albalad D.D.; Alcaide C.M.; Caballero J.; Cervantes A.C.; de Nadal Clanchet M.; Estruch N.M.; Ferrer M.B.; Fornells A.L.; Galera E.T.; Martinez I.G.; Munoz S.M.; Pelavski A.; Perez P.T.; Posada M.A.G.; de Prat I.C.; Rello J.; Serrano L.G.; Sieiro J.M.N.; Silva L.; Sole M.J.C.; Sune A.B.; Villach I.R.; Herreras J.I.G.; Poves R.; Rafael B.M.; Almeida I.M.; Collates A.F.; Bartolome M.J.; Cimadevilla B.; Gonzalez A.M.G.; Llevot J.M.R.; de Teran Mira J.C.D.; Molina B.G.; Pardo S.; Sanchez C.L.; Williams M.; Zaldibar E.; Corsini L.M.; Fraile J.R.R.; de la Lastra M.; Sacramento M.K.; Sana F.J.L.; Alvarez J.T.; Bulnes M.L.C.; Carrasco V.G.; del Rocio Miguez Crespo M.; Cubillos D.N.; Laza E.L.; del Pino Heredia Perez M.; Seisdedos A.A.; Torres B.F.; Ampuero M.S.; Llano M.C.; Mata E.; Munoz M.; Orts M.; Planas A.; Ramasco F.; Roman C.; Duran M.V.; del Rio Fernandez S.; Otero Y.S.; Pineiro S.L.; Pardal C.B.; Alcantud J.F.; Antolinos M.A.; Barrios F.; Casanova A.C.; Castro M.R.; Crespo B.I.; Felipe U.L.; Fuster M.L.; Garcia M.S.; Garrote B.H.; Gonzalez R.M.; Granero M.J.M.; de la Guia C.L.; Lopez R.C.; de Frutos Lopez S.; Martinez J.J.M.; Mostaza A.G.; Moreno A.J.; Osado I.R.; Perez M.R.; Pina M.A.; Romero C.A.; Rodriguez E.R.; Salvan J.H.; Sampedro M.G.; de la Torre P.A.; Toro J.P.; Unzue C.L.; Vargas M.J.; Bernal D.G.; Echevarria M.; Iglesias A.U.; Loza A.; Morillo A.R.; Serrano P.D.; Sevilla F.C.B.; Cacho E.; Calderon R.; Dufur M.; Marginet C.; Monedero P.; Yepes M.J.; Alvarez L.R.; Carballal F.F.; Castineiras A.P.; Garcia P.D.; Lopez L.R.; Maceiras P.R.; Puente M.S.M.; Rilo M.T.R.; Alonso A.E.T.; Fernandez S.R.; Garcia R.O.; Garcia A.P.; Puentes R.B.; Aguado D.N.; Carballo C.L.; Fernandez R.F.; Presedo A.T.; de Rabago R.B.D.; Velasco A.R.; Capel Y.J.; Cortes A.F.; Garcia E.M.; Gimeno L.M.; Klamburg J.; Omedas R.C.; Nunez M.G.; Maristany C.L.; Ruiz E.M.; Artigas X.; Castrillon S.; Espinosa N.; Gomez-Caro A.M.; Illa S.; India I.; Martin-Huerta B.; Moral V.; Moreno M.; Fernandez C.I.; Garcia V.F.; Hernandez P.P.; Checa A.A.H.; Diaz D.S.; Noguera M.L.; Varela I.P.; Gonzalez Gallego M.A.; Garcia O.M.; Irujo J.J.A.; Perrino C.G.; Picazo J.R.; Timoneda F.L.; Arroyo M.M.; Blanco I.A.; Borja M.M.; Burcio S.M.; Castro N.M.; Cerdeirina A.P.; de la Torre Concostrina M.; Cristina M.V.; Diaz T.D.; Esteruelas J.A.; Ingelmo I.I.; Insuga P.D.; Llamas E.C.; Lopez J.J.M.; Martin M.B.; Martin E.E.; Mesa E.U.; Monterde M.L.; Montoiro P.A.; Mostoles M.L.G.; Olarte E.V.; Perez A.M.; Perez F.D.; Romero A.S.; Rous D.P.; Ruiz N.M.; Ruiz J.A.P.; Saiz A.R.; de la Vega Terol A.; Toha A.C.; Utrera F.A.; Alberdi F.; Elosegui I.; Garcia J.; Garde P.M.; Mintegui E.I.; Saez I.G.; Salas E.; Zabarte M.; Diaz-Boladeras R.-M.; Mora-Guevara E.; Zamora J.F.; Bonet A.; Salo L.; Salinas U.; Zaballos J.M.; Alvarez A.A.; Garrido C.J.; Roa J.R.H.; Vidal F.G.; Garcia-Egea J.; Elson M.Z.; Seron-Arbeloa C.; Asensio M.A.M.; Simeon R.G.; Alameda L.E.M.; Angulo G.O.; Aranzubia M.; Arcas J.J.; Arevalo J.; Belvert B.Q.; Calvo C.P.; Cremades M.; Crespo P.; Cuarental A.; Del Olmo M.; Fernandez P.T.; Vega J.L.F.G.I.G.; Herrera E.; Llorente M.A.A.; Rabes C.M.; de Maeyer A.G.; Marquez M.P.; Mendoza D.L.; Munoz J.M.M.; Martinez N.A.; Oviedo A.S.; Garrigues P.B.; Inigo J.A.; Ferrandiz S.T.; Sanchez-Morcillo S.; Sanchez M.L.; Parra A.M.; Vidal S.G.; Allue R.M.; Etayo B.Z.; Rodriguez R.B.; Villen L.M.; Jimenez C.M.; de Zayas R.S.; Moreno C.D.; Pacheco F.S.; Pascual J.L.A.; Gude F.T.; Riestra E.M.; Delgado F.C.; de la Torre Prados M.V.; Barrios J.; Cervera-Montes M.; Garcia-Sanz M.; Garcia V.; Sanmiguel G.; Alvaro J.L.; Barrachima B.B.; Bermejo F.J.R.; Garcia A.G.F.P.M.; Ramirez C.N.; Ramos J.G.; Samaniego L.A.; Belenguer-Muncharaz A.; Ferrandiz-Selles A.; Mateu-Campos M.-L.; Dominguez D.; Espinosa E.; Leon T.; Betancor N.O.; Canalechevarria A.M.; Novales B.F.; Pena J.M.G.; Delgado T.R.; Roquerio B.S.; Sainz J.J.G.; Soto T.T.; Dahm P.; Herges H.O.; Lundborg C.; Seeman-Lodding H.; Sondergaard S.; Rylander C.; Sari F.; Tibblin A.O.; Adolfsson A.; Klarin B.; Schrey S.; Chew M.S.; Merisson E.; Ryden J.; Divander M.B.; Hedin A.; Hedlund D.; Lindkvist M.A.; Jawad M.; Layous L.; Wernerman J.; Bjorne H.; Brattstrom O.; Olheden S.; Oldner A.; Sellden E.; Walder B.; Wickboldt N.; Rossi A.; Steiner L.; Djurdjevic M.; Lussmann R.; Geisen M.; Hofer C.; Turina M.; Everett L.; Ha
Intraoperative transfusion practices in Europe
No full text\ua9 2016 The Author. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. Background: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. Methods: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. Results: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl-1 and increased to 9.8 (1.8) g dl-1 after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). Conclusions: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl-1), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold
Intraoperative transfusion practices in Europe
No full textBACKGROUND:
Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe.
METHODS:
We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013.
RESULTS:
The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl(-1) and increased to 9.8 (1.8) g dl(-1) after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2).
CONCLUSION:
Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl(-1)), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold.
CLINICAL TRIAL REGISTRATION: NCT 01604083
Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications
No full textBACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients.
OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs.
DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification.
PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries.
MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes.
RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure.
CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome
Pathological findings associated with the updated European Society of Cardiology 2022 guidelines for preoperative cardiac testing: an observational cohort modelling study
No full textBackground: In 2022, the European Society of Cardiology updated guidelines for preoperative evaluation. The aims of this study were to quantify: (1) the impact of the updated recommendations on the yield of pathological findings compared with the previous guidelines published in 2014; (2) the impact of preoperative B-type natriuretic peptide (NT-proBNP) use for risk estimation on the yield of pathological findings; and (3) the association between 2022 guideline adherence and outcomes. Methods: This was a secondary analysis of MET-REPAIR, an international, prospective observational cohort study (NCT03016936). Primary endpoints were reduced ejection fraction (EF<40%), stress-induced ischaemia, and major adverse cardiovascular events (MACE). The explanatory variables were class of recommendations for transthoracic echocardiography (TTE), stress imaging, and guideline adherence. We conducted second-order Monte Carlo simulations and multivariable regression. Results: In total, 15,529 patients (39% female, median age 72 [inter-quartile range: 67–78] yr) were included. The 2022 update changed the recommendation for preoperative TTE in 39.7% patients, and for preoperative stress imaging in 12.9% patients. The update resulted in missing 1 EF <40% every 3 fewer conducted TTE, and in 4 additional stress imaging per 1 additionally detected ischaemia events. For cardiac stress testing, four more investigations were performed for every 1 additionally detected ischaemia episodes. Use of NT-proBNP did not improve the yield of pathological findings. Multivariable regression analysis failed to find an association between adherence to the updated guidelines and MACE. Conclusions: The 2022 update for preoperative cardiac testing resulted in a relevant increase in tests receiving a stronger recommendation. The updated recommendations for TTE did not improve the yield of pathological cardiac testing
Development and validation of a score to predict postoperative respiratory failure in a multicentre European cohort : A prospective, observational study
No full textBACKGROUND Postoperative respiratory failure (PRF) is the most frequent respiratory complication following surgery. OBJECTIVE The objective of this study was to build a clinically useful predictive model for the development of PRF. DESIGN A prospective observational study of a multicentre cohort. SETTING Sixty-three hospitals across Europe. PATIENTS Patients undergoing any surgical procedure under general or regional anaesthesia during 7-day recruitment periods. MAIN OUTCOME MEASURES Development of PRF within 5 days of surgery. PRF was defined by a partial pressure of oxygen in arterial blood (PaO2) less than 8 kPa or new onset oxyhaemoglobin saturation measured by pulse oximetry (SpO(2)) less than 90% whilst breathing room air that required conventional oxygen therapy, noninvasive or invasive mechanical ventilation. RESULTS PRF developed in 224 patients (4.2% of the 5384 patients studied). In-hospital mortality [95% confidence interval (95% CI)] was higher in patients who developed PRF [10.3% (6.3 to 14.3) vs. 0.4% (0.2 to 0.6)]. Regression modelling identified a predictive PRF score that includes seven independent risk factors: low preoperative SpO(2); at least one preoperative respiratory symptom; preoperative chronic liver disease; history of congestive heart failure; open intrathoracic or upper abdominal surgery; surgical procedure lasting at least 2 h; and emergency surgery. The area under the receiver operating characteristic curve (c-statistic) was 0.82 (95% CI 0.79 to 0.85) and the Hosmer-Lemeshow goodness-of-fit statistic was 7.08 (P = 0.253). CONCLUSION A risk score based on seven objective, easily assessed factors was able to predict which patients would develop PRF. The score could potentially facilitate preoperative risk assessment and management and provide a basis for testing interventions to improve outcomes. The study was registered at ClinicalTrials.gov (identifier NCT01346709)
Intraoperative transfusion practices in Europe
No full text© 2016 The Author. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.Background: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. Methods: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. Results: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl-1 and increased to 9.8 (1.8) g dl-1 after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). Conclusions: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl-1), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold
Sex dependence of postoperative pulmonary complications – A post hoc unmatched and matched analysis of LAS VEGAS
No full textStudy objective: Male sex has inconsistently been associated with the development of postoperative pulmonary complications (PPCs). These studies were different in size, design, population and preoperative risk. We reanalysed the database of ‘Local ASsessment of Ventilatory management during General Anaesthesia for Surgery study’ (LAS VEGAS) to evaluate differences between females and males with respect to PPCs. Design, setting and patients: Post hoc unmatched and matched analysis of LAS VEGAS, an international observational study in patients undergoing intraoperative ventilation under general anaesthesia for surgery in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs in the first 5 postoperative days. Individual PPCs, hospital length of stay and mortality were secondary endpoints. Propensity score matching was used to create a similar cohort regarding type of surgery and epidemiological factors with a known association with development of PPCs. Main results: The unmatched cohort consisted of 9697 patients; 5342 (55.1%) females and 4355 (44.9%) males. The matched cohort consisted of 6154 patients; 3077 (50.0%) females and 3077 (50.0%) males. The incidence in PPCs was neither significant between females and males in the unmatched cohort (10.0 vs 10.7%; odds ratio (OR) 0.93 [0.81–1.06]; P = 0.255), nor in the matched cohort (10.5 vs 10.0%; OR 1.05 [0.89–1.25]; P = 0.556). New invasive ventilation occurred less often in females in the unmatched cohort. Hospital length of stay and mortality were similar between females and males in both cohorts. Conclusions: In this conveniently–sized worldwide cohort of patients receiving intraoperative ventilation under general anaesthesia for surgery, the PPC incidence was not significantly different between sexes. Registration: LAS VEGAS was registered at clinicaltrial.gov (study identifier NCT01601223)
The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study
No full textInternational audienceBackground: It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average ΔP (ΔP TW) with PPCs. We also tested the association of ΔP TW with intraoperative adverse events. Methods: Posthoc retrospective propensity score-weighted cohort analysis of patients undergoing open or closed abdominal surgery in the 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events
