77 research outputs found

    A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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    Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

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    Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

    Measurements of prompt charm production cross-sections in pp collisions at s=5 \sqrt{s}=5 TeV

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    See paper for full list of authors - All figures and tables, along with any supplementary material and additional information, are available at this https URL - Submitted to JHEPInternational audienceProduction cross-sections of prompt charm mesons are measured using data from pp collisions at the LHC at a centre-of-mass energy of 5TeV. The data sample corresponds to an integrated luminosity of 8.60±0.33pb−1 collected by the LHCb experiment. The production cross-sections of D0, D+, D+s, and D∗+ mesons are measured in bins of charm meson transverse momentum, pT, and rapidity, y. They cover the rapidity range 2.0<y<4.5 and transverse momentum ranges 0<pT<10GeV/c for D0 and D+ and 1<pT<10GeV/c for D+s and D∗+ mesons. The inclusive cross-sections for the four mesons, including charge-conjugate states, within the range of 1<pT<8GeV/c are determined to beσ(pp→D0X)=1190±3±64ÎŒbσ(pp→D+X)=456±3±34ÎŒbσ(pp→D+sX)=195±4±19ÎŒbσ(pp→D∗+X)=467±6±40ÎŒbwhere the uncertainties are statistical and systematic, respectively
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