3 research outputs found
Cutaneous leishmaniasis mimicking cutaneous lymphoma
- Author
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2019
- Field of study
Cutaneous leishmaniasis (CL) is caused by protozoa of Leishmania genus that are transmitted to humans through the bite of sand flies (Lutzomyia and Phlebotomus). The infection is classically manifested as multiple or single ulcers affecting cutaneous and/or mucosal areas of the body. Atypical lesions are relatively uncommon, being able to simulate a large variety of benign and malign dermatological disorders. In this article, we described a case of CL mimicking a clinical presentation of cutaneous lymphoma. Keywords: Cutaneous leishmaniasis, Lymphoma, Differential diagnosi
SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study
- Author
- Aaqil Shah
- Aaron Sanchez
- Abd Almonem Shaikh Ahmad
- Abdelrahman Shehata
- Abdelrahman Shehata
- Abdul Sillah
- Abdulkader Shaar
- AbdulRahman Sari
- Abdurrahman Abba Sheshe
- Abhishek Samuel
- Abhishek Sharma
- Abida K Sattar
- Abigail Sarmiento
- Abigail Semple
- Abrham Shitaw
- Abu Talha Siddiqui
- Adriana Scamporlino
- Agathe Seguin-Givelet
- Ahmad Sayasneh
- Ahmad Shokry
- Ahmed Elshawadfy Sherif
- Ahmed Emad Sayed Hassan
- Ahmed S Sedik
- Ahmed Samir Farahat
- Ahmed Seleim
- Ahmed Shabana
- Ahmed Shaheen
- Ahmed Shehta
- Ahmed Shirazi
- Ahmet Can Sarı
- Ahmet Necati Sanli
- AileÌn SaÌnchez Cruz
- Aina Serra
- Aisulu Sarmenova
- Ajay Savlania
- Alaa Sharabi
- Alasdair Santini
- Alejandro Sanchez Arteaga
- Alejandro Sanchez Pellejero
- Aleksandar SekulicÌ
- Alexandra Schwartz
- Alexandra Sharpe
- Alexandra Shlomina
- Alexey Shilyaev
- Ali Samkari
- Ali Shafiee
- Aliaa Shamardal
- Alima Satanova
- Alistair Savage
- Alphonse Marie Sibomana
- Alvaro Eduardo SaÌnchez HernaÌndez
- Alvaro Sanchez Barrueco
- Aly Sanad
- Amaia Sanz Larrainzar
- Amal Shukri
- Aman Sethi
- Amanda Shen
- Amatallah Hadi Shamsan
- Ami Shah
- Amin Siddig
- Amit Sastry
- Amjad Shah
- Amr Shalaby
- Ana Carolina Scintini Herbst
- Ana Maria Simono Charadan
- Ana SaÌnchez Gollarte
- Ana SaÌnchez Mozo
- Ana Senent-Boza
- Anand Sanmugam
- Andrea Sangheli
- Andrea Sanz Llorente
- Andrea Schmedding
- Andrea Simic
- Andreas Scheiwiller
- Andreas Schnitzbauer
- Andreea-Madalina Serban
- Andrei Shulgin
- Andrew Schache
- AndreÌs SaÌnchez-GoÌmez
- Aneela Shaheen
- Angelino Sanna
- Aniqa Shahzad
- Ankit Sarin
- Ann Stephany Sanchez Marmolejos
- Anna Sayers
- Anna SaÌnchez LoÌpez
- Anneka Shah
- Anshumala Shukla Kulkarni
- Anton H Schwabegger
- Antonia Schulte
- Antonio Luciano Sarni
- Antonio Mario Scanu
- Antonio SanchiÌs LoÌpez
- Antonio Santoro
- Anu Sandhya
- Anushka Sieunarine
- Anwar Sadat Seidu
- Anwar Shamandi
- Arjun Shajpal
- Arnaldo Neves Santos Silva
- Arshad Siddiqui
- Arunkumar Sekar
- Ashish Lal Shrestha
- Ashish Sharma
- Ashleigh Sercombe
- Astad Sidhwa
- Athanasios Saratziotis
- Athanasios Saratzis
- Athish Shetty
- Atif Sharif
- Atsushi Sawada
- Atsushi Seichi
- AureÌlien Scalabre
- Ayesha Shaukat
- Aymen Shafqat
- Ayten Saracoglu
- Ayushi Shukla
- Azka Shaheen
- Babak Siavashi
- Balasupramaniam Sathesan
- Balqis Shawer
- Barbara Seeliger
- Barış Sevinç
- BaÌrbara Segura-MeÌndez
- Benedikt SchaÌfer
- Benedikt Schmid
- Benjamin Scott
- Berta Serrano
- Bhaskar Satsangi
- Birte Schmidt
- Blagoj Shuntov
- Blanca Santos
- Bonnie Sheu
- Brasil Silva Neto
- Brooke Short
- Bruno Sensi
- Burmaa Sanjaa
- Bushra Sayeh Mohamed Elhabashi
- Camilo Sandoval
- Can Sarica
- Carlos Ferreira Dos Santos
- Carlos San Miguel
- Carlos Sanchez Rodriguez
- Carlos Santacruz
- Carlos Shiraishi Zapata
- Carmen Emanuela Scandura
- Carmen Siebenhofer
- Catherine Sarre
- Catherine Shaw
- Catriona Shenton
- Chabwera Shumba
- Charlie Saunders
- Cherith Semple
- Christian Schauer
- Christian Schineis
- Christie Hok Yung Shum
- Christoph SchaÌffer
- Christoph SchmolmuÌller
- Christopher Scott
- Claire Sharpin
- Clarisa Simon Perez
- Claudia Sarrais Polo
- Claudia Scherl
- Codin Saon
- Concepcion Segura
- Cristian Sandu
- Cristina Sanz
- Cristina SaÌnchez Del Pueblo
- Cristina SaÌnchez Torralvo
- Dagim Shimelash
- Dainius Simcikas
- Daleen Shehadeh
- Daniel Sanabria
- Daniel Sanchez-Pelaez
- Daniel Schlager
- Daniel SchoÌni
- Daniel Selvaraj
- Daniel Serralta de Colsa
- Daniel Shaerf
- Darya Shlyk
- David Selwyn
- Deana Shenaq
- Denise Sievers
- Dennis Serrano
- DeÌbora Schalge Campioto
- Diana Santana
- Diego Samudio
- Diego Sasia
- Diego Schaps
- Dima Simona
- Dimiter Shinkov
- Dimitrios Schizas
- Dimitrios Sfoungaris
- Dimple Sapre
- Divya Sarin
- Djayanti Sari
- Dmitry Shkarupa
- Dmitry Shmatov
- Donald Schweitzer
- Dorien Schneidmueller
- Dr Abhishek Sarkar
- Dr Afroz Satpathy
- Dr Ali Shami
- Dr Ashraf Shoma
- Dr Shweta Shetye
- Dr Zamir Ahmad Shah
- Dragan Serghei
- Duaa Sheikh Kadro
- Edgar Sanz
- Edoardo Segalini
- Ehab Shiban
- Ekaterina Semina
- Eleazar Santana
- Elio Fabio SaÌnchez CorteÌs
- Elisa Scarnecchia
- Elisa Sebastiani
- Elise Sarjanoja
- Elva Marita Sarte
- Ema Santos
- Emil Schemitsch
- Emily Shih
- Emma-Tina Segall
- Emmanuel Schneck
- Enrico Sartori
- Erdene Sandag
- Eric Shumba
- Erin Scott
- Erin Sergey
- Ernesto SaÌnchez Castillo
- Esraa Sayed
- Faaiz Ali Shah
- Fabienne Schochter
- Fabrizio Scognamillo
- Fagun Shah
- Farah Shaheen
- Farakh Shahzad
- Fareed Showqi
- Farokh Savaddar
- Farrukh Ozair Shah
- Fateh Sher
- Fatima Sanchez Cabezudo Noguera
- Fatima Serhan
- Fatima Tuz Zahra Shakir
- Fatma Sefi
- FaÌtima SaÌnchez FernaÌndez
- FaÌtima Sena-Ruiz
- Federica Scolari
- Fernando Sevilla
- Filip Sianos
- Francesca Simonelli
- Francesco Selvaggi
- Franck K Sikakulya
- Françoise Schmitt
- Frederique Sauvat
- Gagandeep Sandhu
- Gary Schwartz
- Georg Scheriau
- Gerald Seitinger
- Getachew Shumye
- Ghada Shalaby
- Ghaidaa Sanjuq
- Gianluca Matteo Sampietro
- Gianmarco Saponaro
- Gilbert Samuel
- Giorgio Saraceno
- Giulia Sedda
- Giulio Santoro
- Giuseppe Sammarco
- Giuseppe Sarpietro
- Giuseppe Sica
- Giuseppe Simone
- Goran SÌantak
- Gowthanan Santhirakumaran
- GoÌtz Schmidt
- Gregory Senofsky
- Guido Sciaudone
- Guillermo Alberto Sarmiento Ramirez
- Guillermo Sanchez-VillasenÌor
- Gursev Sandlas
- Habie Samuel
- Hafiz Saqib Sikandar
- Hafiz Syed Zaigham Ali Shah
- Haleema Siddique
- Hannah Sellars
- Hany Shoreem
- Harriet Shearman
- Harsha Shanthanna
- Haseeb Seriwala
- Hassan Shaukat
- Helena Silveira
- Helmut Alfredo Segovia Lohse
- Hemant Sheth
- Henry Shapiro
- Herald Rene Segovia Lohse
- Herman Sehmbi
- Hernan Sandoval
- Hijab Siddique
- Hiroyuki Seki
- Hoda Sherif
- Hrishikesh Sarkar
- Hugo Santos-Sousa
- Husam Sarayrah
- HuÌsnuÌ Şevi K
- Ian Shyaka
- Ian Simel
- Ifeoluwa Shoyombo
- Ikumi Sawada
- Imraan Sardiwalla
- Imtiaz Ahmed Shakir
- Inderpaul Samra
- IneÌs Isabel Sampaio da NoÌvoa Gomes Miguel
- Ingmar Seiwerth
- Ioannis Sarantitis
- Ioannis Siasios
- Ipsit Shah
- Irena Sesar
- Irena Shiderova
- IreÌne Santos
- Irvita Sharma
- Isabel Sanchez Cuadrado
- Isabel Simal Badiola
- Isabelle Schmit
- Isaie Sibomana
- Ismael Sedano-Portillo
- Ismail Sert
- Jack Sample
- Jan Armelynn Santos
- Jan Schirnhofer
- Janahan Sarveswaran
- Jasem Seba
- Jaspreet Kaur Seehra
- Javier Sanchez Gonzalez
- Javier Serrano GonzaÌlez
- Jean Paul Shumbusho
- Jeancarllo Silva
- Jeannie Shen
- Jenardan Sellathurai
- Jerette Schultz
- Jessica Shoemaker
- Jigar Shah
- Joana San Anton
- Joel JesuÌs SaÌnchez EstupinÌan
- Johannes Sander
- John Ashutosh Santoshi
- John Sandoval
- Jonathon Sheen
- Jonida Selmani
- JordaÌn SchernÌuk
- Jorge Dos Santos Silva
- Jorge Sancho-Muriel
- Jorge Santos
- Jorge Sanz Romera
- Jos EÌ Santos
- Jose Maria Silva Barandiaran
- Josefin Segelman
- Josep M Segur
- Joseph Sferra
- Joseph Shalhoub
- JoseÌ Antonio SaÌnchez MartiÌnez
- JoseÌ Ignacio SaÌnchez MeÌndez
- Joud Shiekhoni
- Joudy Shurbatji
- Juan JoseÌ Segura-Sampedro
- Juan RamoÌn Sanz
- Julia Siebert
- Julie Sanders
- Julie Sijmons
- Justin Gabriel Schlager
- Justina Seyi-Olajide
- Justina Shikongo
- K T Matthew Seah
- Kai Sheng Saw
- Kaitlyn Sharp
- Kalai Shaw
- Kamilla Schmitz Nunes
- Kanesh Kumaran Seevalingam
- Karim Shenit
- Karishma Shah
- Karl Schwaiger
- Kathryn Schaffer
- Kemal Saracoglu
- Kenji Shigemi
- Ketan Shah
- Khaled Sarraf
- Khursheed Ahmed Samo
- Kibruyisfaw Shumbash
- Kiran Sarfraz
- Kirill Shostka
- Kohila Sigamoney
- Kozo Sato
- KristiaÌn SÌimko
- Lars SchroÌder
- Laura Sandland-Taylor
- Laura SaÌnchez Blasco
- Leonie Siemen
- Lesley Sheach
- Lilian Schwarz
- Liliana Sequeira
- Liliana Silva-Igua
- Lisa Shea
- Lokesh Sasatti
- Lorenzo Scardina
- Lorna Scullion
- Luc HerveÌ Samison
- Lucio Selvaggi
- Lucy Scott
- Ludmila Sidorova
- Luigi Simonelli
- Luis SaÌnchez-GuilleÌn
- Madiha Saqib
- Madiha Shahid
- Mafalda Sampaio-Alves
- Mahmoud Mohamed Mohamed Shalaby
- Mahmoud Shaban
- Majd Sheikh Alganameh
- Malin Simlund
- Mamta Shah
- Manaf Sharabaji
- Manjunath Siddaiah-Subramanya
- Maphios Siamuchembu
- Marc-Olivier Sauvain
- Marcello Schiavo
- Marco Sandoval Vaez
- Marco Santos
- Margaret Shi
- Margherita Serra
- Maria Juliana Sanchez
- Maria Serra Guivernau
- Maria Shemetova
- MariaÌn SedlaÌk
- Marina SaÌnchez Robles
- Mario Santinami
- Marisa Domingues Santos
- MariÌa JoseÌ SanguÌesa
- MariÌa Liz SaÌnchez
- MariÌa SaÌnchez-Rubio
- MariÌa Sol Siliato Robles
- MariÌa Victoria SimoÌn Sanz
- Mark Seamon
- Mark Simmons
- Marta Santos EspiÌ
- Marta Seid
- Martijn Schoneveld
- Marwah Shilfeet
- Marwan Shorman
- Maryam Sherwani
- Masaki Shiota
- Masamitsu Sanui
- Mat Salleh Sarif
- Mathilde Sarlabous
- Matteo Santoliquido
- Matteo Serenari
- Matthew Sargent
- Matthew Short
- Mauricio Sandoval Tobar
- Md Abu Sayed
- Mee Hoong See
- Melissa Silva
- Mennatallah Sheta
- Mercedes Sanz
- Mert Mahsuni Sevinc
- Michael Sander
- Michael Sander
- Michael Shaw
- Michael Shinkwin
- Miguel Sanfeliu Giner
- Miguel SaÌnchez SuaÌrez
- Miguel SemiaÌo
- Milena Senica Verbic
- Mishary Shalhoub
- Miski Scerif
- Mogahid Sharfeldein
- Mohamad Sankari
- Mohamad Shareeda
- Mohamed Nafea Shaar
- Mohamed Sawalem
- Mohamed Serour
- Mohamed Shalaby
- Mohamed Shalaby
- Mohamed Sharshar
- Mohamed Shemeis
- Mohamed Sherief
- Mohamed Shetiwy
- Mohamed Shoukry
- Mohammad Nour Shashaa
- Mohammad Salman Siddiqi
- Mohammad Sanwar
- Mohammed Mouaz Shebani
- Mohammed Sbaih
- Mohammed Shahine
- Mohammed Shawqy
- Mohammed Sheriff
- Mohammed Shwin
- Momen Shawk
- Monica Serrano-Navidad
- Monira Sarih
- Moritz Schirren
- Mosa Shibani
- Mosab Shetiwy
- Moses Shodipo
- Mostafa Ahmed Shehata
- Mostafa Shalaby
- Mousa Sifat
- Muhammad Ahsan Iqbal Siddiqui
- Muhammad Assam Sarwar
- Muhammad Ather Siddiqi
- Muhammad Harris Siddique
- Muhammad Shah
- Muhammad Shakeel
- Muhammad Sharif
- Muhammad Sher E Murtaza
- Muhammad Zeeshan Sarwar
- Mujuni Samson
- Mumtaz Sarang
- Munjal Shah
- Murat Şen
- Nada Santrac
- Najat Shaban Ben Hasan
- Narendra Babu Siddaiah
- Nashat Siddiqui
- Naveen Sharma
- Nawras Shaban
- Nazanin Shahrokhi
- Nedal Semreen
- Neha Sethi
- Neil Sharma
- Nele Schmidt
- Nelson Silva
- Nevena SavkovicÌ
- Nicholas Schembri
- Nicholas Segaren
- Nicolas Schlegel
- Nicoleta Aurelia Sanda
- Nidhal Siddig
- Nikolay Shefer
- Niranjan Sathianathen
- Nis Schlesinger
- Nomaan Sheikh
- Noullet SeÌverine
- Noura Shujaa
- Nuria Sierra
- Odongo Samuel
- Okazaki Satoshi
- Okello Simon Peter
- Olga Ioulia Semkoglou
- Oliver Lauridsen Siaw
- Oliver Schnell
- Olivia Lumiap Serevina
- Olivier Scatton
- Ondrej Simetka
- Oscar Alejandro SaÌnchez GarciÌa
- Oscar Santes Jasso
- Oscar Serrano
- Pablo Scher
- Paolo Sapienza
- Parisah Seyed-Safi
- Patricia Serrano MeÌndez
- Patricia Shinondo
- Patricio Santillan-Doherty
- Patrick Schuss
- Patrick Schwartz
- PatriÌcia Santos
- Paulo Santos-Costa
- Pedro Saraiva
- Pedro Serralheiro
- Peter Schemmer
- Philipp Schredl
- Pierpaolo Sileri
- Pilar Santos Cidon
- Pradeep Brijkishor Sharma
- Prakash Shetty
- Prassannah Satasivam
- Predrag Savic
- Premalatha Sharavanan
- Priya Shankar
- Pushp Sankhwar
- Qusai Semrin
- Qutaiba Shah Mardan
- Raahil Shah
- Rabab Shaban Ben Hasan
- Rachel Saunders
- Rachel Savoy
- Rachel Shadbolt
- Radu Razvan Scurtu
- Raffaele Sechi
- Raghuram Sekhar
- Rahul Deo Sharma
- Rahul Saxena
- Raja Khalid Shabbir
- Rakesh Shah
- Ramazan Sarı
- Ramon Sieira-Gil
- Raquel Segura RoselloÌ
- Rasheed Shalabi
- Raza Sayyed
- Rebecca Schembri
- Reem Sayad
- Reham Shehada
- Renato Seracchioli
- Riad Sarkis
- Riaz Hussain Siddiqui
- Ricardo SaÌo Pedro
- Riccardo Schiavina
- Richard J Shemin
- Richard Sandkamp
- Richard Schulick
- Richard Shaw
- Rina SepuÌlveda
- Rita Sapage
- Rita Silva
- Roberto Santambrogio
- Rohan Shetty
- Rolf Schneider
- Roman Santana Santana
- Romil Shah
- Rosa Sanz-Gonzalez
- Rosa SaÌnchez
- Rose Seiberth
- Rubem Alves Silva Junior
- Rui Santos
- Rupert Scott
- Ruth Christine SchaÌfer
- S Ali Raza Shehrazi
- Safdar Sarwar
- Safia Siddiqui
- Said Sharawi
- Sajid Shah
- Saleh Sandoughdaran
- Salem Shaat
- Sally Shepherd
- Salma Selim
- Samantha Siahetiong
- Samar Shalaby
- Sameh Sarsik
- Sameh Shehata
- Samuel Sebastian
- Sana Shagour
- Sana Shaikh Torab
- Sandra Sanz
- Sanjeewa Seneviratne
- Sanket Sadanand Shetty
- Santhosh Kumar Sampengere Annayappa
- Santhosh Shivashankar Chikkanayakanahalli
- Santiago SaÌnchez-CabuÌs
- Sara Seegert
- Sarah Shamim
- Sarah Shiels
- Sarah Shream
- Sarbpreet Sarao
- Sari Samman
- Sato Satoshi
- Satyanarayan Sankhwar
- Saurav Sarkar
- Saydash Shamsutdinov
- Sayed Shah Nur Hussein Shah
- Scott Schimpke
- Sean Ezekiel Seow
- Sebastian Shu Yip
- Segun Segun-Busari
- Sena Sefera
- Sera Sarsam
- Seyyed Hossein Shafiei
- Shafaque Shaikh
- Shahila Sheik
- Shahrima Sheefat
- Shahzad Shamim
- Shaikh Sanjid Seraj
- Shaima Sayad
- Shashank Shekhar
- Shayan Shahidi
- Sheena Seewoonarain
- Sherief Shawki
- Shigehito Sawamura
- Shilpa Sharma
- Shivakumar Shankar
- Shomik Sengupta
- Sikachov Sergei
- Silvia Santiago Maniega
- Silvia Segattini
- Sissy-Amelie Schulz
- Sivendran Seevanayagam
- SiÌlvia Silva
- Smruta Shanbhag
- Sohei Satoi
- Srdjan Saso
- Srujan Sharma
- Stefan Schmidbauer
- Stefano Scabini
- Steffen Seyfried
- Stephanie Savage
- Sudip Sanyal
- Sudip Shakya
- Suliman Shah
- Susannah Shore
- Sushruta Shrivastava
- Suzette Samlalsingh
- Taariq Shaikh
- Taha Ismail Sefrioui
- Taher Sawadi
- TainaÌ Santos Bezerra
- Takeshi Sasaki
- Tal Shahar
- Tanisha Sharma
- Tanishq Sharma
- Tanveer Shafqat
- Tarik Sammour
- Tariq Azam Siddiqi
- Tatjana Savic Jovanovic
- Teddy Saputra
- Tedesco Silvia
- Thabet Sayed Bakir
- Theodoros Sidiropoulos
- Thiago Henrique Sigoli Pereira
- Thilo Maria Schulte
- Thomas Schroeppel
- Thomas Seisen
- Tin Sein
- Tinashe Shoko
- Tjokorda Gde Agung Senapathi
- Tobias Schaetz
- Tobias Schlesinger
- Tolulope Olayinka Sayomi
- Tomislav SecÌan
- Tony Shaju
- Toshiya Shiga
- Ts Shylasree
- Tsuyoshi Sano
- Tunde T Sholadoye
- Ugam Shah
- Umberto Scovazzi
- Ushma Shah
- Usman Siddique
- Valentin Schreiter
- Vanessa Sanchez Torrents
- Vanessa Savopoulos
- Varun Sarodaya
- Vicente Simo
- Victor Santos
- Vijay Sharma
- Vijay Shetty
- Vinay Shah
- Vincenzo Scorcia
- Vinita Sangai
- Vinno Savelli
- Violeta SÌetka-CÌuljak
- Vlad Silaghi
- Vuk SÌcÌepanovicÌ
- Walid Shaban
- Wan Nee Shue
- William Shelker
- Yael Sandler
- Yaron Shargall
- Yashwant Shelke
- Yassmeen Sharafeldin Mohammed
- Yi Th Ng Seow
- Yuri Sekiya
- Zahid Shafiq
- Zain Saqfalhait
- Ziyan Sheng
- Zoe Seymour
- Publication venue
- Publication date
- 01/01/2021
- Field of study
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
- Author
- Aarts Frits
- Ababneh Hazim
- Abad-Motos Ane
- Abaidalla Ahmed
- Abbakar Malaz
- Abd El Aal Ahmed
- Abd-Errazik Mohammad Ahmad
- Abdalradiy Abdalrahmman G
- Abdelkhalek Mohamed
- Abdelkhalek Mostafa
- Abdellatif Ahmed
- Abdellatif Mohamed
- Abdelsaid Kirolas
- Abdou Khaled
- Abdulfatah Mustapha
- Abdullah Mohammad Amer
- Abdullahi Mustapha Miko Mohammed
- AbellĂĄn Antonio Melero
- Abeysinghe Nayana
- Abiyere Henry
- Achimas-Cadariu Patriciu Andrei
- Adakaya Sıla
- Adam Nicolas
- Adams Benita
- Adams Ferdinand
- Adegboye Kazeem
- Adeyeye Ademola
- Adra Lama
- Adu-Poku Patricia
- Afuwape Oludolapo
- Afzal Ameer
- Afzal Muhammad Farooq
- Agapov Mihail
- Agara Daniel
- Aggarwal Manisha
- Agger Erika
- Aghadi Ifeanyi Kene
- Ahmed Amjed Yassir
- Ahmed Haleemasahdia
- Ahmed Khalil
- Ahmed Manar
- Ahmed Masood
- Ahmed Safia
- Ahn Hong Min
- Aibe Raquel
- Aigner Felix
- Aissat Abdenour
- Aitbaeva Arai
- Akay Omer
- Akbar Ali
- Akbas Ahmet
- Akere Abidemi
- Akesen Selcan
- Akgun Erhan
- Akhtar Naseem
- Akın Emrah
- Akova Elif
- Aktas Serhat
- Akçay Ăzlem
- Al Masri Mahmoud
- Al-Alnsi Ahmed
- Al-Hutheifi Roqia'A
- Al-Jarrah Amar
- Al-Naggar Hamza
- Al-Shehari Mohammed
- Alamin Nadeen
- Alawi Raneen
- Alawlaqi Dina
- Alawneh Fade
- Alberola Maria José
- Albers Michael
- Alcolea Natalia GonzĂĄlez
- Aleem Muhammad
- Alegre InĂȘs
- Alegre Javier Martinez
- Alexandre Flavia
- Alexandrescu Corina
- Alexnder Abelevich
- Alexopoulou Kalliopi
- Alfonso Beatriz AmorĂłs
- Ali Ahmed
- Ali Che Saniati Che
- Ali Danish
- Ali Madeeha
- Ali Mahmoud Abdelwahab
- Ali Manhal Hashim
- Ali Noura Al
- Alikhanli Jhale
- Aliyeva Zumrud
- Aliyu Mohammed
- Aljawder Hasan
- Allen Kate
- Almahmeed Ebrahim
- Alonso Alfredo
- Alonso Javier Etreros
- Alsamneh Muneer
- Alsayadi Ramzi
- Altinel Yuksel
- Altintoprak Fatih
- Altomare Donato F
- Alvarenga Isabella
- Alvarez Laura Jimenez
- Alvarez-Bautista Francisco Emmanuel
- Alvarez-DĂez Marcos
- Alves Brenda Chayanny
- Amadigwe Rita
- Amado Andreia
- Amado FabĂola
- Amador Cristina GarcĂa
- Amanullah Nazli
- Amaral HĂ©lida Aline Tomacheski
- Amaral Luis
- Amin-Tai Hizami
- Aminu Bashiru
- Amir Ahmad Suhaimi
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- Umar Garzali Ibrahim
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- Wang Jaw Yuan
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- Wanshantha Dinamulla
- Waqar Usama
- Ward Nicholas
- Watanabe Jun
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- Westzaan Natalia
- Wickramarathne Rasika
- Wickramasinghe Dakshitha
- Widatalla Abu Bakr H
- Widyaningsih Rizky
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- Wilson Jeremy
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- Yakunina Natalia
- Yalkin Ămer
- Yanishev Alexey
- Yao Hongwei
- Yazici Pinar
- Yemez Kursat
- Yew Chor Kuan
- Yılmaz GĂŒlseren
- Yilmazlar Tuncay
- YiÄit Direnç
- Yoldas Tayfun
- Yonekura Hiroshi
- Yorkmui Liu
- Yoshino Kenji
- Younes Lina
- Young Trudi
- Yule Michael
- Yusoff Zakiah Mohd
- Zaari Fatimazahraa
- Zabiyaka Mikhail
- ZadroĆŒna Monika
- Zafar Madiha
- Zagaynov Eugeny
- Zaidi Syed-Nadeem
- Zaimis Tilemachos
- Zain Wan Zainira Wan
- Zainy Rhendra Hardy Mohamad
- Zakaria Andee Dzulkarnaen
- Zakaria Maheen
- Zakaria Zaidi
- Zamudio-Bautista Jorge Luis
- Zanc Loredana
- Zanoni Andrea
- Zanus Giacomo
- Zapparoli Alessandro
- Zappone Anna
- Zarzava Eirini
- Zatari Dirar
- Zawadzki Marek
- Zayakov Georgi
- Zaycev Andrey
- Zazo Aya
- Zazo Rama
- Zdravkovic Maja
- Zengin Abdullah KaÄan
- Zeringa Georgia
- Zimmerman David D E
- Zuhdy Mohammad
- Zvirych Vitalii
- Zywicka Ewa
- Ălvarez-Llano Laura
- Ăngelo Miguel Duarte
- ĂSullivan Sara Nuñez
- Ăzçelik Mehmet Faik
- Äoza Ivo
- Ćanlı Ahmet Necati
- Publication venue
- Publication date
- 01/01/2023
- Field of study
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)