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

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

Hochtemperatur-Supraleiter-Systeme in der Satellitenkommunikation. Leistungstaugliche Hochfrequenz-Resonatoren und -Filter in planarer HTSL-Technologie Abschlussbericht

Goal of the R and D project was the development of miniaturized HTSC resonators and filters. The work was divided into two main packages: (#alpha#) Systematic investigations of thin film samples, manufactured by partners of the common project as well as the development of characterization methods. (#beta#) Considerations of all relevant topics related to the design and manufacturing of high power filters with given specifications. The power handling capability of thin films is the most challenging issue in film production. A large variation in film quality could be observed that can cause problems in the realization of HTSC components. Employing the introduced concept of edge current free disk and ring resonators, high power HTSC filters can be realized with an improvement of 400 in power handling capability compared to other HTSC resonator types. During optimization of the unloaded quality factor, dielectric losses were identified to be the limiting factor. Two-pole, four-pole Chebyshev and four pole elliptic filters were developed and characterized and showed low loss and high power handling capability. (orig.)Die Zielsetzung des F und E-Vorhabens war es, stark miniaturisierte leistungstaugliche Resonatoren und Filter auf der Basis von Hochtemperatur-supraleitenden Duennfilmen zu entwickeln. Die Arbeiten gliederten sich in zwei Teilbereiche: Einerseits wurden Methoden zur Hochfrequenz-Charakterisierung der zugrundeliegenden HTSL-Schichten entwickelt und systematische Untersuchungen an Proben schichtherstellender Verbundpartner durchgefuehrt. Andererseits wurden alle relevanten Teilprobleme zur Entwicklung hochleistungstauglicher Filter bearbeitet und entsprechende Problemloesungen entwickelt. Bei der Schichtherstellung stellte sich die geforderte Leistungstragfaehigkeit der HTSL-Schichten als besondere Herausforderung dar. Es wurde eine grosse Streuung der Filmqualitaet beobachtet, wodurch die Realisierung von Bauelementen erschwert werden kann. Die Realisierung leistungstauglicher Filter ist mit dem vorgeschlagenen Scheibenresonator-Konzept moeglich, welche eine um den Faktor 400 hoehere Energiespeicherung im Vergleich zu anderen HTSL-Strukturen erlauben. Bei der Optimierung der Leerlaufguete stellten sich dielektrische Verluste als begrenzender Faktor heraus. Es wurden sukzessive Zweipolfilter, 4-polig Tscherbyscheff-Filter und 4-polige quasi-elliptische Filter entwickelt und charakterisiert. (orig.)Available from TIB Hannover: F99B1258+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Bildung und Forschung (BMBF), Bonn (Germany)DEGerman