8 research outputs found
Fractura por fatiga de un tallo de revisión femoral modular cónico estriado de fijación distal.
No full text1. Engelbrecht E, Heinert K. Klassifikation und Behandlungsrichtlinien von Knochensubsanzverlusten bei Revisionsoperationen am Huftgelenk mittelfrsige Ergebnisse. Primare und Revisionsalloarthroplastik Hrsg-Endo-Klinik, Hamburg: Springer-Verlag, Berlin; 1987:189.
2. Merle d’Aubigné R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 1954;36:451.
3. Hood RW, Wright TM, Burstein AH. Retrieval analysis of total knee prostheses: a method and its application to 48 total condylar prostheses. J Biomed Mat Res 1983;17:829.
4. Carlsson AS, Gentz CF, Stenport J. Fracture of the femoral prosthesis in total hip replacement according to Charnley. Acta Orthop Scand 1977;48:650-5.
5. Chao EYS, Coventry MB. Fracture of the femoral component after total hip replacement. An analysis of fifty-eight cases. J Bone Joint Surg Am 1981;63:1078-94.
6. Charnley J. Fracture of femoral prostheses in total hip replacement. A clinical study. Clin Orthop 1975;111:105.
7. Buttaro M, Mayor M, Van Citters D, Piccaluga F. Fracture of a proximally modular, distally fluted uncemented implant with diaphyseal fixation. J Arthroplasty 2007;22(5):780-3.
8. Bohm P, Bischel O. Femoral revision with the Wagner SL revision stem: evaluation of one hundred and twenty-nine revisions followed for a mean of 4.8 years. J Bone Joint Surg Am 2001;83(7):1023.
9. Woolson ST, Milbauer JP, Bobyn JD, Yue S, Maloney WJ. Fatigue fracture of a forged cobalt-chromium-molybdenum femoral component inserted with cement. A report of ten cases. J Bone Joint Surg Am 1997;79(12):1842
Fractura por fatiga de un tallo de revisión femoral modular cónico estriado de fijación distal
No full text1. Engelbrecht E, Heinert K. Klassifikation und Behandlungsrichtlinien von Knochensubsanzverlusten bei Revisionsoperationen am Huftgelenk mittelfrsige Ergebnisse. Primare und Revisionsalloarthroplastik Hrsg-Endo-Klinik, Hamburg: Springer-Verlag, Berlin; 1987:189.2. Merle d’Aubigné R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 1954;36:451.3. Hood RW, Wright TM, Burstein AH. Retrieval analysis of total knee prostheses: a method and its application to 48 total condylar prostheses. J Biomed Mat Res 1983;17:829.4. Carlsson AS, Gentz CF, Stenport J. Fracture of the femoral prosthesis in total hip replacement according to Charnley. Acta Orthop Scand 1977;48:650-5.5. Chao EYS, Coventry MB. Fracture of the femoral component after total hip replacement. An analysis of fifty-eight cases. J Bone Joint Surg Am 1981;63:1078-94.6. Charnley J. Fracture of femoral prostheses in total hip replacement. A clinical study. Clin Orthop 1975;111:105.7. Buttaro M, Mayor M, Van Citters D, Piccaluga F. Fracture of a proximally modular, distally fluted uncemented implant with diaphyseal fixation. J Arthroplasty 2007;22(5):780-3.8. Bohm P, Bischel O. Femoral revision with the Wagner SL revision stem: evaluation of one hundred and twenty-nine revisions followed for a mean of 4.8 years. J Bone Joint Surg Am 2001;83(7):1023.9. Woolson ST, Milbauer JP, Bobyn JD, Yue S, Maloney WJ. Fatigue fracture of a forged cobalt-chromium-molybdenum femoral component inserted with cement. A report of ten cases. J Bone Joint Surg Am 1997;79(12):1842
SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study
No full text5202noneengSARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.noneNepogodiev D.; Simoes J.F.F.; Li E.; Picciochi M.; Glasbey J.C.; Baiocchi G.; Blanco-Colino R.; Chaudhry D.; AlAmeer E.; El-Boghdadly K.; Wuraola F.; Ghosh D.; Gujjuri R.R.; Harrison E.M.; Lule H.; Kaafarani H.; Khosravi M.; Kronberger I.; Leventoglu S.; Mann H.; Mclean K.A.; Mengesha M.G.; Modolo M.M.; Ntirenganya F.; Norman L.; Outani O.; Pius R.; Pockney P.; Qureshi A.U.; Roslani A.C.; Satoi S.; Shaw C.; Bhangu A.; Omar O.M.; Ahmed W.-U.-R.; Argus L.; Ball A.; Bywater E.P.; Brar A.; Dawson B.E.; Duran I.; Elhadi M.; Jones C.S.; Kamarajah S.K.; Keatley J.M.; Lawday S.; Marson E.J.; Ots R.; Santos I.; Taylor E.H.; Trout I.M.; Varghese C.; Venn M.L.; Xu W.; Dajti I.; Gjata A.; Kacimi S.E.O.; Boccalatte L.; Cox D.; Townend P.; Aigner F.; Kronberger I.E.; Samadov E.; Alderazi A.; Hossain K.; Padmore G.; van Ramshorst G.; Lawani I.; Cerovac A.; Delibegovic S.; Gomes G.M.A.; Buarque I.L.; Gohar M.; Slavchev M.; Nwegbu C.; Agarwal A.; Martin J.; Ng-Kamstra J.; Olivos M.; Lou W.; Ren D.-L.; Calvache J.A.; Perez Rivera C.J.; Hadzibegovic A.D.; Kopjar T.; Mihanovic J.; Jimenez P.M.A.; Gouvas N.; Klat J.; Novysedlak R.; Amisi N.; Christensen P.; El-Hussuna A.; Batista S.; Lincango-Naranjo E.; Emile S.; Sandoval D.A.A.; Dhufera H.; Hailu S.; Mengesha M.G.; Kauppila J.H.; Arnaud A.P.; Demetrashvili Z.; Albertsmeier M.; Lederhuber H.; Loffler M.W.; Acquah D.K.; Ofori B.; Tabiri S.; Metallidis S.; Tsoulfas G.; Aguilera-Arevalo M.-L.; Recinos G.; Mersich T.; Wettstein D.; Kembuan G.; Milan P.B.; Khosravi M.H.; Mozafari M.; Hilmi A.; Mohan H.; Zmora O.; Gallo G.; Pata F.; Pellino G.; Fujimoto Y.; Kuroda N.; Abou Chaar M.K.; Ayasra F.; Fakhradiyev I.; Hamdun I.H.S.; Jin-Young J.; Jamal M.; Karout L.; Gulla A.; Rasoaherinomenjanahary F.; Samison L.H.; Sanchez I.I.D.; Gonzalez D.S.; Martinez L.; Martinez M.J.; Nayen A.; la Medina A.R.-D.; Nunez J.; 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Parodi M.; Molina H.P.; Pinsak A.; Viscido G.; Badra R.; Belisle D.; Borla H.; Eberle G.; Esteban A.; Ferrero C.I.; Furlan M.; Garcia J.S.; Granero L.; Henzenn M.; Juaneda R.; Vidal E.P.; Reyna G.R.; Montero J.G.Y.; Caubet M.M.; D'Addino J.L.; Daryanani D.; Gosselink M.; Ponson A.; Afzal M.; Amprayil M.; Brooke-Smith M.; Chen J.; Grantham J.; Gricks B.; Hii A.; Kundu N.; Liu D.; Livingston C.; Marshall-Webb M.; McVeay C.; Moore H.; Nair G.; Ong B.S.; Parker D.; Rudolph-Stringer V.; Szpytma M.; Vissapragada R.; Wee M.Y.; Wong G.Y.M.; Barnett D.R.; Bochner M.; Bolt J.; Buddingh K.; Coventry B.; Davis S.; Dawson J.; Denham S.; Dobbins C.; Fitridge R.; Gan S.W.; Haque I.-U.; Herath M.; Jog S.; Kanhere H.; Kuang B.; Lam Y.H.; Lambert V.; Lim A.; Maina G.; Moller C.-C.; Neo E.N.; Neo E.L.; Nguyen A.; Prasad S.; Roy J.; Russell C.; Sammour T.; Smith N.; Smith R.; Stranz C.; Tourani S.; Tran S.; Van de Ven L.; Warren L.; Whitfield R.; Wormald J.; Yin Y.; Bierton C.; Cribb B.; Foley K.; Ong D.; 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SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study
No full text5202openengSARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.openNepogodiev D.; Simoes J.F.F.; Li E.; Picciochi M.; Glasbey J.C.; Baiocchi G.; Blanco-Colino R.; Chaudhry D.; AlAmeer E.; El-Boghdadly K.; Wuraola F.; Ghosh D.; Gujjuri R.R.; Harrison E.M.; Lule H.; Kaafarani H.; Khosravi M.; Kronberger I.; Leventoglu S.; Mann H.; Mclean K.A.; Mengesha M.G.; Modolo M.M.; Ntirenganya F.; Norman L.; Outani O.; Pius R.; Pockney P.; Qureshi A.U.; Roslani A.C.; Satoi S.; Shaw C.; Bhangu A.; Omar O.M.; Ahmed W.-U.-R.; Argus L.; Ball A.; Bywater E.P.; Brar A.; Dawson B.E.; Duran I.; Elhadi M.; Jones C.S.; Kamarajah S.K.; Keatley J.M.; Lawday S.; Marson E.J.; Ots R.; Santos I.; Taylor E.H.; Trout I.M.; Varghese C.; Venn M.L.; Xu W.; Dajti I.; Gjata A.; Kacimi S.E.O.; Boccalatte L.; Cox D.; Townend P.; Aigner F.; Kronberger I.E.; Samadov E.; Alderazi A.; Hossain K.; Padmore G.; van Ramshorst G.; Lawani I.; Cerovac A.; 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SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study
No full textnone5201siSARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (>= 7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3-6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. 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Mishra T.; Sekar A.; Gupta A.; Kaman L.; Karthigeyan M.; Tripathi M.; Rammohan A.; Vayoth S.O.; Rajanbabu A.; Subbian A.; Gupta R.; Raut M.; Evelyn N.; Kannaiyan R.L.; Matai A.; Misra S.; Bhende V.; Muthu S.; Ghosh I.; Sharma A.; Bajaj A.; Rajan S.; Agarwal G.; Pawar P.; Alexander P.; Vijayakumar M.V.; Hameed Z.; Badareesh L.; Chaudhry N.K.; Baliarsing L.; Dharap S.; Kulkarni A.; Thyavihally Y.; Sharma R.D.; Pramesh C.S.; Soni R.; Dube S.K.; Sharma S.; Singh H.; Bains L.; Ghodke R.; Kumar A.; Sodhai V.; Maji S.; Basu S.; Mahakalkar C.; Kannan R.; Mehraj A.; Ranganath N.; Phadnis A.; Yadev I.; Kavalakat A.; Mittal R.; Vallam K.C.; Akhavizadegan H.; Maleki E.R.; Kandevani N.Y.; Ikele H.; McNestry C.; Fleming C.; O'Brien S.; Elwahab S.A.; Davis N.; Javadpour M.; McDonnell B.; Connor C.O.; Bolger J.; Clancy C.; Croghan S.M.; Donlon N.; Cullinane C.; Creavin B.; Muheilan M.; Earley H.; Kabir S.M.U.; Fahadullah M.; Ryan E.; Connelly T.; Hashimoto D.; Alqudah M.A.; Alajalen A.; Omari R.Y.; Qasem A.; Alawneh Y.; Ahmad A.; Aladawi O.; Alrayes B.; Haidar H.; Husain S.; Qassem F.; Sumadi A.; Salhiyeh A.A.; Al-Manaseer B.M.; Alsunna Z.; Ra'ed H.; Hamad F.R.B.; Abuleil A.; Jimaale E.A.M.; Abu-Mehsen M.; Olaywah N.; Wafi O.; Ababneh H.; Abu-Ismail L.; Khamees A.; Alkhatib A.; Bolatbekova R.; Kulimbet M.; Nurgozhin T.; Saliev T.; Zhussupov B.; Almabayev Y.; Kaidarova D.; Tamoos K.; Aqeelah A.; Mohammed A.A.K.; Al Maadany F.; Alkadeeki G.; Gahwagi M.; Aldressi W.; Amnaina M.; Alansari A.H.A.; Alkaseek A.; Yagoub G.; Amer A.B.; Salem M.; Almugaddami A.; Burgan D.; Abdelkabir M.; Alshareef K.; al Islam Ben Jouira R.; Meelad A.; Bouhuwaish A.; Dwaga S.E.; Khalifa H.; Almiqlash B.; Suliaman T.; Alawami M.; Elhajdawe F.; Aboazamazem H.; Ellojli I.; Msherghi A.; Saleh I.A.; Alayan M.; Ndayishyigikiye M.D.; Munyika A.; Plarre P.; Borowski D.W.; Wells C.; Teague R.; Elliott B.; Kieser D.; Mohyieldin O.; McIntosh N.; Haran C.; King J.; Ha J.; McGuinness M.J.; Adesanya O.; Olaogun J.; Akinmade A.; Bwala K.; Agbonrofo P.; Afolabi A.; Usang U.; Ekenze S.; Olori S.; Lawal T.A.; Okunlola A.; Kache S.; Sale D.; Anyanwu L.-J.; Okereke C.; Tolani M.A.; Filipce V.; Todorovic L.; Stavridis S.; Massoud J.G.; Alsibai S.; Sultan R.; Altaf H.N.; Bhatti A.B.H.; Waqar S.H.; Aziz A.; Kerawala A.A.; Rai L.; Anwer M.; Tariq A.; Ayub B.; Niazi S.U.; Naseem M.Y.; Sarwar M.Z.; Khokhar M.I.; Zahid I.A.; Majid H.J.; Talat N.; Asif M.; Chaudhary M.H.; Farooq U.; Ahmad S.; Mabood W.; Bukhari S.I.; Tariq M.; Yaqoob E.; Javed S.; Malik M.U.; Yaqoob H.N.; Pacheco G.M.F.; Melendez R.M.; Urbina A.D.P.P.; Chiuyari J.R.; Alvarado C.E.O.; Lau L.F.R.; Borda-Luque G.; Niquen-Jimenez M.; Arias C.; Zegarra S.; Pallardel J.B.; Oscco R.A.U.; Mendiola G.; Colmenares Y.T.C.; Zapata C.S.; Ortiz M.R.; Borges F.C.; Viveiros O.; Serralheiro P.; Santos-Costa P.; Mendes F.; Melo M.R.; Cardoso P.; Soares A.; Pereira R.G.; Silva N.; Caiado A.; Sacras M.L.; Azevedo P.; Almeida-Reis R.; Oliveira J.; Nogueiro J.; Sampaio-Alves M.; Costa L.C.; Baia C.; Deus A.C.; Branquinho R.; Marcal A.; Tojal A.; Makkai-Popa S.T.; Mironescu A.; Grama F.; Toma E.A.; Filipescu D.; Bacalbasa N.; Motas N.; Ionescu S.; Ginghina O.; Costea R.; Zarnescu N.O.; Drasovean R.; Dimofte M.-G.; Porumb V.; Kirov M.; Molitvin Y.; Pykhteev V.; Raevskaya M.; Butyrskii A.; Alshahrani M.; Althumairi A.; Alzerwi N.; Al Ameer A.; Madkhali T.; Almulhim A.S.; Ghazwani S.; Ayoub A.; Iskander O.; Ghunaim M.; Alharthi M.; Alzaidi T.M.; Alyami M.; Al Amri A.; AlFakhri A.; Alhefdhi A.; Chowdhury S.; Nouh T.; Alshehri A.; Alzahrani A.; Alalawi Y.; Awad S.; Konate I.; Tendeng J.; Teo N.Z.; Aqil S.; Lopez C.B.; Mozo A.S.; Infante A.R.; Vivancos P.C.; Prieto M.; Roman I.A.S.; Fernandez L.G.; Vives J.M.M.; Carreras-Castaner A.; Diaz-Feijoo B.; Sieira-Gil R.; Turrado-Rodriguez V.; Lopez A.S.; Sanchez-Cabus S.; Toscano M.J.; Sin M.C.; Laura S.G.; Sole O.M.; Bellver P.P.; Perez-Bertolez S.; Prat-Ortells J.; Martinez M.R.; Rubio-Palau J.; Tarrado X.; Nunez J.; Mendoza V.A.; Bescos C.; Espin-Basany E.; Espinosa-Bravo M.; Gil-Sala D.; Gonzalez-Suarez S.; Estruch N.M.; Marino L.P.; Rodriguez-Tesouro A.; Portilla F.R.; Perez M.P.T.; Vives I.; De Cortazar U.G.; Tudela K.; Landaluce-Olavarria A.; Gomez M.E.; Almoguera J.; Ugarte-Sierra B.; Jimenez V.; Bertrand M.; Puiggros L.C.; Delisau-Puig O.; Garcia-Adam ez J.; Bergkvist D.J.; Maldonado-Marcos E.; Garcia L.D.; Golet M.R.; Soto-Darias I.; Rahy-Martin A.C.; Enjuto D.; Ramos-Luengo A.; Fernandez J.D.; Duarte C.L.; Thies C.O.; Marquez L.; Vita D.C.; Dziakova J.; Velasco J.C.; Mateo-Sierra O.; Quintana-Villamandos B.; Valcarcel C.R.; Rio J.; de Leon L.R.G.; Di Martino M.; Prada J.; Gonzalez J.S.; Losada M.; Gomez J.T.C.; Corripio-Sanchez R.; Forero-Torres A.; Morales-Puebla J.M.; Perez-Chrzanowska H.; Gonzalez S.V.; Yebes A.; Zapardiel I.; Alonso M.D.; Palacios N.M.; Sanchez A.C.; Fernandez F.S.; Gurumeta A.A.; Abad-Motos A.; Corella F.; Ripolles-Melchor J.; Sanz-Gonzalez R.; Fuentes M.A.; Martin M.T.F.; Espino P.C.; Prats M.C.; Fernandez-Lopez A.-J.; Escudero D.G.; Soria V.G.; Alonso J.A.M.; Ruiz-Marin M.; Perez B.G.; Moya-Angeler J.; Martinez D.F.; Bayo H.L.; Colas-Ruiz E.; Romera S.B.; Pellice M.T.G.; Sole M.J.; Velasquez E.J.R.; Nunez B.; Jimenez R.; Zabaleta J.; Gonzalez-Gimeno M.J.; Vazquez I.O.; Ferrer A.P.; Martin-Laez R.; Suarez M.M.; Eiras M.A.F.; Ramallo-Solis I.; Gomez-Rosado J.-C.; Guillen J.R.O.; Boira M.A.; Bauset J.C.C.; Domenech J.; Badenes R.; Bernal-Sprekelsen J.C.; Sancho-Muriel J.; De Andres-Asenjo B.; Tejero-Pintor F.J.; Vallve-Bernal M.; Melero A.V.; Blasco L.S.; Escartin J.; Mallen V.D.; Srishankar S.; Sooriyabandara C.; Basnayake O.; Gunawansa N.; Weeraddana P.D.; Vimalakanthan T.; Gishanthan S.; Chandrasinghe P.; Sauvain M.-O.; Ghazal A.; Al-Sabbagh Y.; Alhassoun T.; Albared S.M.; Naem A.; Alnahr H.; Jisry G.; Hammed A.; Xaviour O.F.; Turinawe G.; Mubezi I.; Sikakulya F.K.; Kakeeto A.; Kabweru W.M.; Kiweewa R.; Matovu P.; Isaac O.; Mashhour M.; El Helw A.; Kherani S.; Mohamed A.; Abbas F.M.A.; Mohammed D.; Aldlyami E.; Kundra R.; Michael A.L.R.; Khalil K.S.; Dbeis R.; Shaikh S.; Ferry J.; Jamal A.; Siddique H.; Das R.; Ponugoti N.; Rattanasirivilai P.; Sultana A.; Mosley F.; Chan M.; Bateman A.; Davies-Jones G.; Georgiades F.; Ahmadi N.; Coonar A.; Baig M.; Khatri C.; Surendran A.; Sonksen J.; Sinnerton R.; Brennan C.; Faulkner G.; Greenhalgh M.; Emerson H.; Singisetti K.; Totty J.; Wilson M.; Lo T.; Corbett H.; Okonkwo I.; Arbane G.; Kerawala C.; Parmar C.; Bath M.; Odejinmi F.; Sagar J.; Talwar R.; Newman S.; Hammond J.; Moir J.; Duric N.; Szakmany T.; Talib A.I.; Youssef M.; Lewis-Lloyd C.; Lami M.; Ayub K.; Dean B.; Balasubramanya S.; Lakpriya S.; Rogers L.; Turner P.; Maher M.; Sigamoney K.; El Kafsi J.; Hardie J.; Johnson D.; Henein C.; Hollyman M.; Agarwal K.; Powell S.; Chauhan G.S.; Patel R.; Gagnier J.; Carmichael H.; Aurora; Olson K.A.; Etchill E.; Hirji S.; Naunheim M.; Drake F.; Reinke C.; Alecci A.; Vaysburg D.; Rodriquez J.; Shih E.; Ban V.S.; Coleman J.; Kaups-Fresno K.; Giorgakis E.; DiNome M.; Bhutiani N.; Alnachoukati O.; Aiken T.; Diehl T.; Gosain A.; Rattan R.; Ghani M.O.A.; Ruzgar N.M.; Liveris A.; Glass N.; Paranjape C.; Chin T.; Meola A.; Nicholson K.; Squiers J.; Lueckel S.; Reisenauer J.; Callcut R.; Mansour A.; Berndtson A.; Kornblith L.; Seegert S.; Martins P.; Al-Shehari M.; Al-Raimi I.; Ngulube A.; Siamuchembu M.; Mushiwokufa W.; Mlambo B.; Chinyowa S.; Bollano E.; Gjyli K.; Kerpaci J.; Vrapi E.; Zijaj L.; Djahida B.; Zohra B.F.; Khadidja K.; Bali O.; Benallel N.; Lalmi I.; Abdoun M.; Aouabed N.; Bouaoud S.; Bouchenak K.; Haif A.; Soualili Z.; Bastet J.; Bianco A.; Capitaine D.; Lozada J.C.; Esquivel C.; Figueroa R.; Garcia M.; Garcia P.M.; Gerchunoff J.I.; Iascano F.M.; Mondino J.; Muriel M.E.; Pablo C.; Passadore M.; Tornini A.; Traverso R.; Vargas L.; Zanoni G.; Berber N.; Cotta E.; Di Vincenzo M.; Gallino E.S.; Gigena C.; Grassano B.; Lugones I.; Madrid C.; Maricic M.; Martinez A.A.; Rosso A.; Scher P.; Tachella S.; Zezular D.I.A.; Abuawad C.; Forneris A.A.; Allemand C.; Calzaretta L.G.A.; Boretto J.G.; Boudou R.; Brandariz R.; Buljubasich M.; Burchakchi A.; Buttaro M.; Campana J.P.; Busnelli V.C.; Carminatti T.; Lalin A.F.C.; Cereghini J.; Amor M.S.C.; Croattini R.S.; Fernandez M.S.; Figari M.; Fraidenraij U.; Gallegos D.; Garcia-Mansilla A.M.; Gonzalez M.; Gonzalez M.I.; Salazar E.G.; Goransky J.; Gauna G.H.; Higuera F.; Holc F.; Jauregui E.G.; Larranaga J.; Liyo J.; Llano L.; Lobos P.; Luzzi E.; Mastroianni G.; Mata-Suarez S.M.; Mayer H.F.; Loughlin S.M.; Mendoza E.; Mentz R.E.; Mercado P.; Moyano P.; Noll F.; Odetto D.; Oliva A.R.; Vidal R.P.; Poggi C.; Premoli E.J.; Ramos M.L.; Rosas P.; Rossi L.; Rossi G.; Saadi J.; Schernuk J.; Slullitel P.; Stang M.V.; Taboada M.V.; Tirapegui S.; Uffelmann C.; Vaccaro C.; Vagni R.; Valerio A.C.; Zarratea C.S.; Montal S.; Morris B.; Valdez P.; Diaz-Couselo F.; Sabatini L.; Alvarez F.A.; Avila M.; Benitez N.B.; Bruera N.; Doniquian M.; Gielis M.; Liano J.; Llahi F.; Mandojana F.; Paez W.; Parodi M.; Molina H.P.; Pinsak A.; Viscido G.; Badra R.; Belisle D.; Borla H.; Eberle G.; Esteban A.; Ferrero C.I.; Furlan M.; Garcia J.S.; Granero L.; Henzenn M.; Juaneda R.; Vidal E.P.; Reyna G.R.; Montero J.G.Y.; Caubet M.M.; D'Addino J.L.; Daryanani D.; Gosselink M.; Ponson A.; Afzal M.; Amprayil M.; Brooke-Smith M.; Chen J.; Grantham J.; Gricks B.; Hii A.; Kundu N.; Liu D.; Livingston C.; Marshall-Webb M.; McVeay C.; Moore H.; Nair G.; Ong B.S.; Parker D.; Rudolph-Stringer V.; Szpytma M.; Vissapragada R.; Wee M.Y.; Wong G.Y.M.; Barnett D.R.; Bochner M.; Bolt J.; Buddingh K.; Coventry B.; Davis S.; Dawson J.; Denham S.; Dobbins C.; Fitridge R.; Gan S.W.; Haque I.-U.; Herath M.; Jog S.; Kanhere H.; Kuang B.; Lam Y.H.; Lambert V.; Lim A.; Maina G.; Moller C.-C.; Neo E.N.; Neo E.L.; Nguyen A.; Prasad S.; Roy J.; Russell C.; Sammour T.; Smith N.; Smith R.; Stranz C.; Tourani S.; Tran S.; Van de Ven L.; Warren L.; Whitfield R.; Wormald J.; Yin Y.; Bierton C.; Cribb B.; Foley K.; Ong D.; Watson M.; Hampton J.; Karam J.; Rugendyke A.; Zhang T.; Vasey C.; Apellaniz E.; Frankel A.; Gahan L.; Guerra G.R.; Liesegang A.; Lutton N.; Maurice A.; Miron S.; Prasad A.; Sercombe A.; Sivapalan T.; Ahmad S.D.S.; Tee C.L.; Yaksich L.; Batstone M.; Breik O.; Young T.; Field M.; Scott B.; Charlton G.; Chen S.; Cheung H.Y.C.; Gauri N.; Hayhurst R.; James S.; Jang S.; Jia F.; Zhang H.; Aujla R.; Finsterwald M.; Percy D.; Tanaya A.; Trivedi A.; Aylett A.; Grills R.; Holmes A.; Kwok M.M.K.; Lambers A.; Lambers L.; Lok E.; Nagra S.; Page R.; Paltoglou N.; Panuganti V.; Riddell S.; Rudock G.; Tan H.; Underwood K.; Youssef D.; Amoils R.; Bahtigur N.; Bengeri S.; Builth-Snoad L.; Cheah H.P.; Chen P.; Chew K.; Chong A.; Clark S.; Kaul R.D.; Devan E.; Ewington C.; Fatima A.; Fitt S.; Gaul J.; Ghosal P.; Gojnich A.; Gunawardena I.; Hamer P.; Holmes S.; Hou Z.; Jolly D.; Kane J.D.; Kaufman M.; Khandelwal T.; Khanijaun S.; Kwok K.; Latif E.; Laura S.; Lee V.; Leung C.; Liang I.; Lin P.; Lun E.W.Y.; Luo H.; Ly V.; Ma J.; Macnab B.; McGee R.; Miles S.; Munro W.; Narroway H.; Ngan T.Y.; Noor A.; Pahalawatta U.; Park M.; Parkin C.; Poon R.; Somasundaram S.S.; Saab C.; Simpson R.; Steinel D.; Taylor E.; Tchen A.; Thong S.; Tran K.; Tree K.; Vance L.; Wong K.; Yu V.; Zhang M.; Cox A.; Tan D.C.H.; Thani N.; Das S.; Macdonald T.; Salama P.; Sandhu G.; Shadbolt R.; Phan D.; Townend D.; Ju E.; Lee S.M.; Barnett S.; Kheslat H.H.; Higgins A.; Jamieson-Grigg C.; Jenkins V.; Larner B.; Perini M.; Proud D.; Qin K.; Riddiough G.; Seevanayagam S.; Wu D.M.; Zhao C.; Aggarwal S.; An V.; Battershell M.; Chan E.; Cheung K.T.; Drake A.; Goonawardena J.; Hunt B.; Ip C.; Iyer V.; Jain A.; Kealey J.; Lew C.; Lim C.S.H.; Luck T.; Mackay S.; Maher N.; Maroske G.; Roubos N.; Sengupta S.; Steen C.; Tsigaras Z.; Tuttle Z.; Ward S.; Williams M.; Yeap E.; Zhou J.; Coates A.; Mutalima N.; Tran T.; Nataraja R.; Sharpin C.; Bird D.; Choy K.T.; Condron S.; Daruwalla J.; dos Anjos I.; El-Khoury H.; Fabian R.; Gillard A.; Greenop R.; Issa M.; Lee S.; Mori K.; Petrakis N.; Qureshi M.; Sabella D.; Satasivam P.; Sathianathen N.; Seow S.E.; Shen A.; Shi M.; Tabassum M.; Teixeira R.; Vivian-Taylor J.; Wheatley J.; Shepherd S.; Soucisse M.; King S.; O'Connor B.; Teague W.; Banting S.; Chong L.; Clatworthy S.; Cochrane A.; Fox A.; Hii M.W.; Isaacs A.; Johnson M.A.; Knowles B.; Newcomb A.; Price V.; Raman J.; Read M.; Rowcroft A.; Taylor L.; Wright G.; Chana P.; Shaw K.; Bock J.; Cory J.; Drummond K.; Lahy J.; McIntire T.; Price B.; Stark C.; Besson A.; Gartrell R.; Lauritz B.; Nguyen H.M.N.; Ong C.F.; Pitcher M.; Scullion L.; Tang H.; Taylor D.; Wolf B.; Wichmann M.; Davis A.; Maurel A.; Raubenheimer K.; Campbell C.; Colaco A.;
Latin American anaphylaxis registry
No full textBackground: Recent data about clinical features, triggers and management of anaphylaxis in Latin America is lacking. Objective: To provide updated and extended data on anaphylaxis in this region. Method: An online questionnaire was used, with 67 allergy units involved from 12 Latin-American countries and Spain. Among data recorded, demographic information, clinical features, severity, triggering agents, and treatment were received. Results: Eight hundred and seventeen anaphylactic reactions were recorded. No difference in severity, regardless of pre-existing allergy or asthma history was found. Drug induced anaphylaxis (DIA) was most frequent (40.6%), followed by food induced anaphylaxis (FIA) (32.9%) and venom induced anaphylaxis (VIA) (12%). FIA and VIA were more common in children-adolescents. Non-steroidal anti-inflammatory drugs (NSAIDs) and beta-lactam antibiotics (BLA) were the most frequent drugs involved. Milk (61.1% of FIA) and egg (15.4% of FIA) in children, and shellfish (25.5% of FIA), fresh fruits (14.2% of FIA), and fish (11.3% of FIA) in adults were the most common FIA triggers. Fire ants were the most frequent insect triggers, and they induced more severe reactions than triggers of FIA and DIA (p < 0.0001). Epinephrine was used in 43.8% of anaphylaxis episodes. After Emergency Department treatment, epinephrine was prescribed to 13% of patients. Conclusions: Drugs (NSAIDs and BLA), foods (milk and egg in children and shellfish, fruits and fish in adults) and fire ants were the most common inducers of anaphylaxis. Epinephrine was used in less than half of the episodes emphasizing the urgent need to improve dissemination and implementation of anaphylaxis guidelines.Revisión por paresODS 3: Salud y BienestarODS 9: Industria, Innovación e InfraestructuraODS 17: Alianzas para lograr los objetivo
Predictors of outcomes after internal fixation of periprosthetic femoral hip fractures Subgroup analysis of the peri-implant and peri-prosthetic fractures Spanish registry (PIPPAS)
No full text20.500.12530/87893Purpose: To identify risk factors predisposing patients to poor outcomes after fixation of periprosthetic hip fractures around femoral stems.Methods: Prospective multicentre cohort study of fractures around a hip replacement stem managed by internal fixation. The primary outcome was one-year mortality, while secondary outcomes were local complications and healthcare burden-related outcomes (nursing facility utilization and hospital length of stay).Results: One-year mortality was 16.2%. Age-adjusted Charlson Comorbidity Index score (OR=1.17; 95%CI=1.031.33)), Pfeiffer Short Portable Mental Status Questionnaire (SPMSQ) score (OR=1.16; 1.06-1.28), prosthetic dysfunction (OR=1.90; 1.00-3.61), and postoperative medical complications (OR=1.97; 1.06-3.68) were predictors of mortality. Patients with prior prosthetic dysfunction, lower Pfeiffer SPMSQ scores, Vancouver A fractures, and fractures fixed only using cerclages were at higher risk of local complications, which occurred in 9.3% of cases. Medical (OR=1.81; 1.05-3.13) and local complications (OR=5.56; 2.42-3.13) emerged as consistent risk factors for new institutionalization. Average hospitalization time was 13.9 +/- 9.2 days. Each day of fixation delay led to an average 1.4-day increase in total hospitalization.Conclusion: Frail periprosthetic hip-fracture patients with poorer functional status, dysfunctional replacements, and postoperative complications are at increased risk of mortality. Postoperative complications are more common in patients with dysfunctional arthroplasties, Vancouver A fractures, and fixation using cerclages alone. Postoperative complications were the most consistent predictor of higher healthcare resource utilization
Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries
No full textBackground:
The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs.
Methods:
First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score.
Findings:
In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1–84·9), which varied between HIC (88·5 [89·0–88·0]), MIC (81·8 [82·5–81·1]), and LIC (66·8 [64·9–68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0–4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1–5·5]; p<0·0001), MIC (2·8 [2·0–3·7]; p<0·0001), and LIC (3·8 [1·3–6·7%]; p<0·0001) settings.
InterpBackground
The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs.
Methods:
First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score.
Findings:
In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1–84·9), which varied between HIC (88·5 [89·0–88·0]), MIC (81·8 [82·5–81·1]), and LIC (66·8 [64·9–68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0–4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1–5·5]; p<0·0001), MIC (2·8 [2·0–3·7]; p<0·0001), and LIC (3·8 [1·3–6·7%]; p<0·0001) settings.
Interpretation:
The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs.retation
The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs
