27 research outputs found

    Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

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    This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

    Characterization of complex groundwater flows in the environment of singular buildings by combining hydrogeological and non‐destructive geophysical (ground‐penetrating radar) techniques: Punta Begoña Galleries (Getxo, Spain)

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    [EN] Locating and quantifying groundwater flow in many built-up areas are a priority with regard to its complete restoration. In this work, a hydrogeological survey of the surroundings of the Punta Begona Galleries (Getxo, Bizkaia), built on a coastal cliff, was completed by using ground penetrating radar (GPR) testing. Thus, the preliminary characterization of soils and rocks in accessible areas of the cliff was first improved by hydrogeological information gathered from a single survey borehole, including permeability measurements by low pressure injection tests (LPTs) and continuous water level monitoring. As a complementary method, the non-destructive GPR technique was performed during both dry and wet hydrological periods and in tandem with the injection tests, providing more complete spatial and temporal images of water flows. Specifically, GPR allows mapping of flow paths in soils and assessing the continuity of fractures in rock masses. Altogether, this complementary approach provides greater knowledge of complex underground flow dynamics in built environments, thus making it easier to make decisions for their managementCity Council of Getxo, Grant/Award Number: OTRI2016-0738; University of the Basque CountryUriarte, JA.; Damas Molla, L.; Sagarna, M.; Aranburu, A.; García García, F.; Antiguedad, I.; Morales, T. (2020). Characterization of complex groundwater flows in the environment of singular buildings by combining hydrogeological and non-destructive geophysical (ground-penetrating radar) techniques: Punta Begona Galleries (Getxo, Spain). Hydrological Processes. 34(4):1004-1015. https://doi.org/10.1002/hyp.136351004101534
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