8 research outputs found
The potential for treatment shortening with higher rifampicin doses : relating drug exposure to treatment response in patients with pulmonary tuberculosis
- Author
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2018
- Field of study
This work was supported by the European and Developing Countries Clinical Trials partnership (grants IP.2007.32011.011, IP.2007.32011.012, and IP.2007.32011.013) and the German Ministry for Education and Research (grant 01KA0901). The original study conducted within the PanACEA consortium.Background: Tuberculosis remains a huge public health problem and the prolonged treatment duration obstructs effective tuberculosis control. Higher rifampicin doses have been associated with better bactericidal activity, but optimal dosing is uncertain. This analysis aimed to characterize the relationship between rifampicin plasma exposure and treatment response over 6 months in a recent study investigating the potential for treatment shortening with high-dose rifampicin. Methods: Data were analyzed from 336 patients with pulmonary tuberculosis (97 with pharmacokinetic data) treated with rifampicin doses of 10, 20, or 35 mg/kg. The response measure was time to stable sputum culture conversion (TSCC). We derived individual exposure metrics with a previously developed population pharmacokinetic model of rifampicin. TSCC was modeled using a parametric time-to-event approach, and a sequential exposure-response analysis was performed. Results: Higher rifampicin exposures increased the probability of early culture conversion. No maximal limit of the effect was detected within the observed range. The expected proportion of patients with stable culture conversion on liquid medium at week 8 was predicted to increase from 39% (95% confidence interval, 37%-41%) to 55% (49%-61%), with the rifampicin area under the curve increasing from 20 to 175 mg/L·h (representative for 10 and 35 mg/kg, respectively). Other predictors of TSCC were baseline bacterial load, proportion of culture results unavailable, and substitution of ethambutol for either moxifloxacin or SQ109. Conclusions: Increasing rifampicin exposure shortened TSCC, and the effect did not plateau, indicating that doses >35 mg/kg could be yet more effective. Optimizing rifampicin dosage while preventing toxicity is a clinical priority.Publisher PDFPeer reviewe
Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study
- Author
- Liza
- - AP-HP) Bertrand Dousset (H\uf4pital Cochin
- - APHP) Anne Thomin (H\uf4pital Trousseau
- - ASST Rhodense) Carlo Corbellin (Ospedale Di Rho
- - NYU Winthrop Hospital) Amir H Sohail (NYU Langone Health
- - Xarxa Assistencial Universit\ue0ria de Manresa) Pablo Collera Ormazabal (Fundaci\uf3 Althaia
- / Columbia University Medical Center) Miriam Callahan (NewYork-Presbyterian
- 3 University Hospital) Bridget Egan (Tallaght
- 4 Lapolla Pierfrancesco
- 5 Spain: Eduardo E Rubio Susana Henriques (Hospital Garcia de Orta).
- 6 G\uf3mez Marcos
- \u2013 IRCCS Francesca Gaino (Humanitas Clinical and Research Center
- \u2013 Italy) 20089 Rozzano (MI)
- \uc1ngel Hern\ue1ndez Bartolom\ue9 Miguel
- A Aaraj Mahmoud
- A Ayeni Funbi
- A Bass Gary
- A Benson Ruth
- A Bozkurt Mehmet
- A Breen Kerry
- A Breen Kerry
- A Breen Kerry
- A Callcut Rachael
- A Chung Eric
- A Coughlin Patrick
- A de Gheldere Charles
- A De Marchi Joshua
- A Elliott Jessie
- A Fahey Brian
- A Griffiths Ewen
- A Griffiths Ewen
- A Griffiths Ewen
- A Guariglia Claudio
- A Hirji Sameer
- A Khalefa Mohamed
- A Marra (Fondazione Policlinico Universitario Agostino Gemelli) Angelo
- A Nguyen (Frankfurt University Hospital Truong
- A Olson (Duke University Medical Center) Steven
- A Raptis Dimitri
- A Rollett Rebecca
- A Saeed Samerah
- A Salama Hiba
- A Salamah Abdulrauf
- A Schnitzbauer Andreas
- A Schnitzbauer Andreas
- A Singh Aminder
- A Stevens Kent
- A Stylianides Nicholas
- A Thaha Mohamed
- A Vega (12 de Octubre University Hospital) Viviana
- A Vivas Alfredo
- A Zappa Marco
- Abate Emmanuele
- Abdalaziz (Gloucestershire Royal Hospital) Hossam
- Abdelkarim Mostafa
- Abdou Hossam
- Aboelkassem-Ibrahim Ahmad
- Abuown Ala
- Acebes-Garcia Fernando
- Acharya Metesh
- Adamina Michel
- Addae-Boateng Emmanuel
- Adolfo Pisanu (Cagliari University Hospital) Mauro Podda
- Aftab Raiyyan
- AG Moir John
- Agarwal Arnav
- AH Ibrahim Mohamed
- Aitken (Queen Elizabeth University Hospital) Emma
- Al-Azzawi Marwa
- Al-Embideen Somya
- Al-Sukaini Ahmad
- Alakaloko Felix
- Alam (Heartlands Hospital) Ruhina
- Alameer Ehab
- Alderson Derek
- Ali Mohamed Ali (Queen Elizabeth Hospital King's Lynn) Inthekab
- Aliyeva (Acibadem Mehmet Ali Aydinlar University Zumrud
- Aljanadi Firas
- Almasri Murad
- Alonso Poza (Hospital Universitario del Sureste) Alfredo
- Alonso-Ortu\uf1o Paula
- Alser Osaid
- Alser Osaid
- Alser Osaid
- Altintoprak (Sakarya University Faculty of Medicine) Fatih
- Amalina Che Bakri Nur
- Amjad Rabbia
- Anania Gabriele
- and Westminster Hospital NHS FT and Imperial College London) Chelsea
- Andabaka Tatjana
- Andrea Pisani Ceretti (ASST Santi Paolo e Carlo) Nicol\uf2 M Mariani
- Angelou Dimitrios
- Anita Volpe (New York Presbyterian Queens) Stephen Merola
- Annamalai Seethalakshmi
- Annessi Valerio
- Anthoney James
- Anuradha R Bhama (Rush University Medical Center) Alfonso Torquati
- Anwar Sibtain
- Aragon-Chamizo Juan
- Ardito Antonella
- Arigoni Michele
- Armao Teodora
- Arminio (Ospedali Riuniti Azienda Ospedaliera Universitaria Foggia) Armando
- Armstrong Lara
- Asaad Peter
- Ashcroft James
- Ashmore Christopher
- Asqalan Ahmad
- Asti (IRCCS Policlinico San Donato Emanuele
- Aubry Emmanuelle
- Aytac Erman
- Ayuso-Herrera Esther
- Azerbaijan:Elgun Samadov Joana FF Simoes (Chair). 2 Collaborators: (denotes Local Principal Investigator) Algeria: Faraj S Almaadany (\uc9tablissement Hospitalier Sp\ue9cialis\ue9 en Canc\ue9rologie - Centre Pierre-et- Marie-Curie).
- B Avellana Rocio
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- B Yousuf (Tobruk Medical Center) Farhat
- B\ue0mbina (Fabrizio Spaziani Hospital Fabrizio
- Bailon-Cuadrado (Hospital Universitario R\uedo Hortega) Martin
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- Baldini Edoardo
- Baldo (Ospedale Santa Corona Stefano
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- Baltazar Gerard
- Bandiera Alessandro
- Barlow Emma
- Barmasse (Ospedale Regionale Umberto Parini) Roberto
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- Baronio (Policlinico San Pietro) Gianluca
- Barra Fabio
- Bartholomew's Hospital) St
- Bartsch Anne-Marie
- Basgaran Amedra
- Basha Amr
- Bashkirova (North Middlesex University Hospital) Varvara
- Bastazza Marco
- BB Sullivan (The Royal London Hospital) Tom
- Beak Philip
- Belcher Elizabeth
- Belgium: Gabrielle H van Ramshorst Sevda Jafarova (Leyla Medical Center).
- Beltr\ue1n de Heredia Juan
- Belvedere Angela
- Ben\uedtez-Linero Inmaculada
- Benjamin Franklin) Campus
- Bergeat Damien
- Bernasconi Matteo
- Bhalla Ashish
- Bhangu Aneel
- Bianco Federica
- Bisagni Pietro
- BJ Borgstein Alexander
- Blake (Southport and Formby District General Hospital) Iain
- Blanco-Colino Ruth
- Blazquez-Martin (Hospital Principe De Asturias) Alma
- Boal Matthew
- Bologna) Ausl
- Bonavina Giulia
- Bonavina Luigi
- Bond-Smith Giles
- Booth (Freeman Hospital) Karen
- Borges Filipe
- Borghi Felice
- Borja De Lacy (Hospital Clinic Barcelona) F
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- Boyle Emily
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- Brain Jessie
- Brar Amanpreet
- Breckles Lisa
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- Brianza) Carate
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- Bueser Teofila
- Burnside Nathan
- C Bosanquet David
- C Brown (Manchester University NHS Foundation Trust Benjamin
- C De Souza Anthony
- C Glasbey James
- C Glasbey James
- C Hopkins James
- C Lauscher Johannes
- C McIntyre Robert
- C Mckay Siobhan
- C Neary Paul
- C Nugent III William
- C Rodriguez-Sanjuan (Marqu\ue9s de Valdecilla University Hospital) Juan
- C Roslani April
- C Tucker Sarah
- C Velmahos (Massachusetts General Hospital) George
- C Winter Stuart
- Caballero Albert
- Cairo University) Mahmoud MA Elfiky (Kasr Alainy Faculty of Medicine
- Calcerrada-Alises Enrique
- Camacho Fern\ue1ndez-Pacheco (Complejo Hospitalario Universitario Insular-Materno Infantil) Borja
- Camarero Enrique
- Campagnaro Tommaso
- Campanelli Michela
- Candiani Massimo
- Cannoletta (Royal Brompton Hospital) Marina
- Cantalejo-Diaz (Hospital Universitario Miguel Servet) Miguel
- Cao Han
- Capizzi Vita
- Carcano (Ospedale di Circolo Giulio
- Carissimi Francesca
- Carlini Massimo
- Carlos Bernal-Sprekelsen Juan
- Carlos Catal\ue1 Bauset (Consorcio Hospital General Universitario) Juan
- Carlucci Michele
- Carmela Giuffrida Maria
- Carmichael Heather
- Carrasco Milagros
- Carrillo Mariana
- Carvello Michele
- Casati Massimiliano
- Castoro Carlo
- Castro Ruiz Carolina
- Catalan Vanesa
- Catriona R Luney (Nuffield Orthopaedic Centre) Benjamin JF Dean
- Cavaleiro Salom\ue9
- Cellerino Paola
- Center Amsterdam) Cancer
- Centinaio (Ospedale Maggiore di Lodi) Giovanna
- Cernei Cristina
- Cervellera Maurizio
- Chakrabortee Sohini
- Chamberlain Stephanie
- Chan Jeffrey
- Chang Grace
- Chaudhry Daoud
- Chebaro Alexandre
- Chen (Jamaica Hospital) David
- Chetty Govind
- Chia (Royal Derby Hospital) Zoe
- Chiappini Ambra
- Chiarugi (Azienda Ospedaliero Universitaria Pisana) Massimo
- Chidambaram Swathikan
- Chiozza Matteo
- Cholewa Hanna
- Chong (Evelina London Children's Hospital) Clara
- Choolani-Bhojwani Ekta
- Christian Cotsoglou (ASST Vimercate) Stefano Granieri
- Chui Karen
- Chung Choyin
- Cirillo Bruno
- Citterio Davide
- Clermidi Pauline
- Coccolini Federico
- Colletti Gaia
- Compagnoni Bruno
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- Confalonieri Marco
- Connolly Hannah
- Conso Christel
- Conti Luigi
- Cooper Zara
- Corral Javier
- Costa Marta
- Costanzi Andrea
- Cox Daniel
- Cozza Valerio
- CR Wormald Justin
- Croatia: Jakov Mihanovic Nicolas Duchateau (Heilig Hart Ziekenhuis Lier).
- CS Clough Ethan
- Cuming Tamzin
- Cuneo)
- Curtis Miles
- Cuschieri Joseph
- D Baron Ryan
- D Bosch Karen
- D Brown Oliver
- D Bueno-Ca\uf1ones Alejandro
- D Cato Liam
- D Drake Thomas
- D Jenkinson Michael
- D Jenkinson Michael
- D Liyanage Aloka S
- D Pinkney Thomas
- D Rajgor Amarkumar
- D Stewart Grant
- D Tebala Giovanni
- D'Agruma Michele
- D'Andrea Giancarlo
- D\uedaz P\ue9rez David
- D\uedaz-Garc\ueda (Hospital Universitario Nuestra Se\uf1ora de Candelaria) Alberto
- Da Roit Anna
- da Saliceto\u201d Patrizio Capelli (Ospedale \u201cG.
- Dare Oliver
- Darko Ebenezer
- Data Monitoring and Ethics Committee: Deborah S Keller H. Hunt Batjer (University of Texas Southwestern).
- Day Andrew
- De Andr\ue9s-Asenjo Beatriz
- de Medicina Facultad
- De Miguel-Ardevines Maria-Carmen
- De Nardi Paola
- De Simone Veronica
- De Toma Giorgio
- Deepti Sinha (University College London Hospital) Nicholas Kalavrezos
- Dehal (Kaiser Permanente Panorama City Medical Center) Ahmed
- Dehart Dustin
- Del Giudice Roberto
- Delgado-Oliver Eduardo
- Denmark: Henry G Smith Bernarda Bakmaz (Zadar General Hospital).
- Denning Max
- Desai Anant
- Desender (Ghent University Hospital) Liesbeth
- Dester (ASST Valcamonica Ospedale di Esine) Sara
- Di Candido Francesca
- Di Chiara Francesco
- Di Franco Gregorio
- Di Giuseppe (Ente Ospedaliero Cantonale del Canton Ticino) Matteo
- Di Saverio Salomone
- Di Saverio Salomone
- Di Saverio Salomone
- Di Saverio Salomone
- Diaz-Pe\uf1a Patricia
- Dieguez Fernandez Beatriz
- Dissemination Committee: Michel Adamina Aneel Bhangu.
- Dolores Del Toro M
- Domodossola
- Doussot Alexandre
- Duff Sarah
- Dunning Joel
- Dunstan Matt
- Duque-Mallen Victoria
- Dziakova Jana
- E Canova Michaela
- e Carle Hospital Chiara Peluso (Santa Croce
- e Carlo ASST Santi Paolo
- E Dawson Brett
- E Dickson Kathryn
- E Hudson Victoria
- E Jenny (Johns Hopkins Hospital) Hillary
- E Lewis Sophia
- E Nita George
- e Oftalmico) Giulio Iacob (Ospedale Fatebenefratelli
- E P\ue9rez-S\ue1nchez Luis
- E Rice Henry
- E Ssentongo Anna
- e Universit\ue1rio de Coimbra) Ana C Almeida (Centro Hospitalar
- E Xyda Souzana
- Edward Fitzgerald J
- EF Abbott Tom
- EF Abbott Tom
- Egan Richard
- Egypt: Mohamed El Kassas University of Copenhagen).
- El Youzouri Hanan
- El-Ali (Queen's Hospital Abess
- Elaine YL Leung (The Pan Birmingham Gynaecological Cancer Centre) Sudha Sundar
- Elfeki Hossam
- Elhadi Muhammed
- Eljareh (Aljalaa Hospital) Mohammed
- Elkadi Hannah
- Elkady Ramy
- Elkhafeefi Fatimah
- Elmore Ugo
- Elmoslemany (The Walton Centre NHS Foundation Trust) Tarek
- EM Bouhuwaish Ahmad
- EM Brathwaite Collin
- Emmerson (North Manchester General Hospital) Oliver
- Enemosah Ibrahim
- English Camilla
- English William
- Ereidge Simon
- Escartin Jorge
- Estaire-Gomez Mercedes
- EuroSurg
- Evans (Queen Elizabeth the Queen Mother Hospital Margate) Jessica
- Exley Rebecca
- F Bath Michael
- F Cunha Miguel
- F Cunha Miguel
- F Davis Niall
- F Ridgway Paul
- Fabbri Nicol\uf3
- Falco Giuseppe
- Familiari Pietro
- Fancellu (Cliniche San Pietro Alessandro
- Fanjul G\uf3mez Mar\ueda
- Farik Shebani
- Farr\ue9 Font Roser
- Farrell Tony
- Fehervari Matyas
- Fell Adam
- Fern\ue1ndez- Mart\uednez Mar\ueda
- Fern\ue1ndez-Gomez Cruzado (Hospital Urduliz) Laura
- Fern\ue1ndez-Mar\uedn Reyes
- Fernandez-Camu\uf1as Angel
- Ferrara)
- Ferrara Francesco
- Ferrari Guglielmo
- Ferrero Simone
- FF Simoes Joana
- FF Simoes Joana
- Findlay Laura
- Fiore Marco
- Fiore Marco
- Fiori Enrico
- FJ Dunne Declan
- Flatman Michael
- Flindall Ian
- Fontana (Vittorio Emanuele Tommaso
- Ford (The Robert Jones and Agnes Hunt Orthopaedic Hospital) David
- Ford Samuel
- Forlani Stefano
- Fr\ue9d\ue9ric Bretagnol (H\uf4pital Louis-Mourier - GHU AP-HP. Nord - Universit\ue9 de Paris) David Moszkowicz
- France: Zaher Lakkis Mohamed Sherief (MISR Cancer Center/MISR International Hospital).
- Francisco de Vitoria Universidad
- Francone Elisa
- Frattaruolo Colomba
- Frio (Institute of Neurological Sciences of Bologna Federico
- Frosinone)
- G Aoun Salah
- G Barranquero Alberto
- G Blazer III Dan
- G Collins Chris
- G Edwards John
- G Edwards John
- G Morton Dion
- G Povey Meical
- G Velopulos Catherine
- G Wade Ryckie
- Gabriel Kinnaman (IU Health Methodist Hospital) Ashley D Meagher
- Gagliano Annalisa
- Gagliardi Filippo
- Gahunia Sukhpreet
- Gala Tanzeela
- Galfrascoli Elisa
- Galimberti Luca
- Galindo Jara (Hospital Universitario de Torrej\uf3n Pablo
- Gallagher Phoebe
- Galleano Raffaele
- Gallo Gaetano
- Gallo Gaetano
- Gallo Gaetano
- Galv\ue1n-P\ue9rez Armando
- Gamal Amira Ibrahim Sallam
- Gammeri Emanuele
- Ganau Mario
- Garc\ue9s-Garc\ueda Ra\ufal
- Garcia Fernandez Andres
- Garcia-Conde Delgado Maria
- Garulli (Ospedale Infermi di Rimini) Gianluca
- Gascon-Ferrer Isabel
- Gattolin (Regina Montis Regalis Hospital Andrea
- Gaujoux Sebastien
- Gentilli Sergio
- Georgiades Fanourios
- Germany: Carsten Kamphues Didier Ollat (Institut Mutualiste Montsouris).
- Gerogiannis (Kingston Hospital NHS Foundation Trust) Ioannis
- Ghanbari (Homerton University Hospital) Amir
- Ghosh Dhruv
- Giacometti Marco
- Giblin Anna-Victoria
- Gilbert (Surrey and Sussex Healthcare NHS Trust) Catherine
- Gim\ue9nez Clara
- Giorgakis Emmanouil
- Gipponi Manuel
- Glen Paul
- GlobalPaedSurg GlobalSurg
- Goatly Giles
- Gobatti (San Carlo Borromeo Hospital Davide
- Godbole Chintamani
- Gohil Kajal
- Gomez-Rosado Juan-Carlos
- Gonullu Emre
- Gonzalez-De Miguel Melania
- Gonzalez-Gonzalez Enrique
- Gordini Luca
- Gracia Isabel
- Gracia-Roche Carlos
- Greece: Konstantinos Bouchagier Markus W L\uf6ffler (University Hospital Tu\u308bingen).
- Green Susanna
- Grivon Manuela
- Grove (Department of Colorectal Surgery Thomas
- Guaglio Marcello
- Guaitoli (Perrino) Eleonora
- Guglielmi Alfredo
- Guha Soumya
- Gustavino (Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino Genoa) Claudio
- Guti\ue9rrez Samaniego Mar\ueda
- H Babu Bheemanakone
- H Chowdhury Abeed
- H Davidson Giana
- H Davidson Giana
- H Davidson Giana
- H Elfallal Ahmed
- H Emile Sameh
- H Kirmani Bilal
- H Liu Helen
- H Murphy Suzanne
- H van Ramshorst Gabrielle
- H\uf6lzle Frank
- Habeeb Amir
- Hagger Robert
- Hakmi Hazim
- Halkias Constantine
- Halkias Constantine
- Hampton (Rotherham District General Hospital) Matthew
- Handa Siddhartha
- Haq Iram
- Harky (Liverpool Heart and Chest Hospital) Amer
- Harries (Morriston Hospital Rhiannon
- Harrison Joseph
- Hasan Raashad
- Hawari Mohammad
- Hawkin Paul
- Hebblethwaite Bethany
- Helier University Hospitals NHS Trust) St
- Heritage Emily
- Hernandez Garcia Miguel
- Hernandez-Juara Pilar
- Herrero-Lopez Maria
- Hervieux Erik
- Heyd Bruno
- Higgs Simon
- Hitchman (Hull University Teaching Hospitals NHS Trust) Louise
- Ho Beatrice
- Hogan Aisling
- Hospital of Varese University
- Hospital Universitario del Henares) Miguel Angel Garcia-Ure\uf1a (Universidad Francisco de Vitoria
- Hospital) Atakent
- Hospital) Wythenshawe
- Hossain Tanvir
- Houston Roy
- Hurt Libor
- HV Byrne Matthew
- i Pujol) Alba Zarate (Hospital Germans Trias
- I Roxo (Brigham and Women's Hospital) Vanessa
- I van Berge Henegouwen (Amsterdam UMC Mark
- I Alessandro Di Bartolomeo (Policlinico Umberto
- Iannone Immacolata
- Ibrahim Sherif
- Iovino Domenico
- Ireland: Arnold DK Hill Paraskevi Tourountzi (Kavala General Hospital).
- Isik Arda
- Israel: Oded Zmora Thomas M Aherne (Galway University Hospital).
- Italy: Maurizio Zizzo Nadav Kugler (Shamir Medical Center).
- J Abbott Sarah
- J Baker Olivia
- J Baldwin Alexander
- J Beamish Andrew
- J Carlos William
- J Caruana Edward
- J Caruana Edward
- J Davies Emma
- J Diaz Jose
- J Doe Matthew
- J Eardley Nicola
- J Fern\ue1ndez Antonio
- J G\uf3mez D\uedaz Carlos
- J Hainsworth Alison
- J Hall Bria
- J Holme Thomas
- J Hutchinson Peter
- J Hutchinson Peter
- J Kalkwarf Kyle
- J Lin Daniel
- J Lowery Aoife
- J McCluney Simon
- J Mehigan Brian
- J Mills Sarah
- J Pachl (Birmingham Children's Hospital) Max
- J Rogers Luke
- J Ryan \uc9anna
- J Scurrah Rachel
- J Shackcloth Michael
- J Smart Neil
- J Steinkamp Pieter
- J Tejero-Pintor Francisco
- J Thomas Amy
- J Torres Antonio
- J Warren Oliver
- J Warren Oliver
- J Williams Katherine
- James RW Hall (Stepping Hill Hospital) Claire Hall
- James's Hospital) Conor P Barry (St.
- Jamil Tahir
- Jayaraju (University Hospital of Wales) Ullas
- Jenner Edward
- JG Chase Thomas
- Jha Shane Lester (James Cook University Hospital) Madan
- Jimenez-Higuera Elisa
- Jimeno Jaime
- JM Dunne Naomi
- JM Ferguson Henry
- Jo\ue3o Lima Maria
- Johnstone Jack
- Jones Mark
- Jordan: Mahmoud Al-Masri Gela).
- JS Wall Joshua
- Judkins Nicholas
- JW Wilkin Richard
- K Abou Chaar Mohamad
- K Ambler Graeme
- K Bankhead-Kendall Brittany
- K Bankhead-Kendall Brittany
- K Bankhead-Kendall Brittany
- K Brown Allison
- K Fusai Giuseppe
- K Gill Charn
- K Kamarajah Sivesh
- K Patel Panna
- K Ubhi Harmony
- K Weerasinghe Chamindri
- K\uf6nigsrainer Alfred
- Kalidindi Venugopala
- Kamal Mona
- Kang Chong
- Kara Yasin
- Karam Edward
- Karim Ahmed
- Kashora Florence
- KC Jonker (University Medical Center Groningen (University of Groningen) Pascal
- Kearney (Beaumont Hospital) David
- Khajuria Apoorva
- Khan Azam
- Khan Umul
- Khatri Chetan
- Kinross James
- Kler Aaron
- Klimopoulos (Evangelismos General Hospital) Serafeim
- Kocata\u15f (Kanuni Sultan Suleyman Training and Research Hospital) Ali
- Kolias Angelos
- Kolias Angelos
- Kontovounisios Christos
- Kourdouli (Leicester Royal Infirmary) Amar
- Krishnan Emily
- Kristinsson Sverrir
- Kruijff Schelto
- KS Viswanath Yirupaiahgari
- Kudsk-Iversen S\uf8ren
- Kufeji Dorothy
- Kulkarni Rugved
- Kurihara Hayato
- L Biffl Walter
- L Coleman Natasha
- L Collins Michelle
- L Engel (Temple University Hospital) Jamie
- L Fowler Amy
- L Garcia Galocha Jose
- L Hughes Jane
- L J\uf6nsson (Bispebjerg Hospital Maria
- L Labib Peter
- L Marsh (Scripps Memorial Hospital) Christopher
- L McKevitt Kevin
- L Osorio Alexander
- L Romera Jose
- L Serevina Olivia
- L Venn Mary
- L Venn Mary
- L Venn Mary
- L Wright Franklin
- L Young Alastair
- L\ue1zaro Andr\ue9
- La Torre Filippo
- Laface (Ospedale Vittorio Emanuele III Letizia
- Lami Mariam
- Landaluce-Olavarria Aitor
- Laura Hansen 9
- Lawani Ismail
- Lawday (Southmead Hospital) Samuel
- Lawday Samuel
- Le Roy Bertrand
- Lecco) Asst
- Lecolle Katia
- Lederhuber Hans
- Lederhuber Hans
- Leeds)
- Leicester)
- Leventoglu Sezai
- Li Elizabeth
- Li Elizabeth
- Li Zoe
- Libya: Ghadah Z Alkadeeki Hani Al-Najjar (King Hussein Cancer Center).
- Liew Ignatius
- Ligure (SV) Pietra
- Lima Buarque Igor
- Lisi Giorgio
- Lizzi Vincenzo
- Lo Terence
- Lombardia) Regione
- Lomiento Daniele
- Longhi Marco
- Lopez Antonanzas (Hospital Clinico San Carlos Leyre
- Losada Ruiz Manuel
- Lostis Emilie
- Lostoridis Eftychios
- Loubani Mahmoud
- Lowy- Benoliel Alejandro
- Lucianetti (Papa Giovanni XXIII Hospital) Alessandro
- Luigi MP Marino Cosentino (PO San Filippo Neri - ASL ROMA 1) Andrea Sagnotta
- luis Blas Laina Juan
- Luke Evans (Norfolk and Norwich University Hospital) Mina MG Youssef
- Luke Louis
- Lunevicius Raimundas
- Luraghi Marco
- Lye George
- M Alrahawy (Menofiya University Hospital) Mahmoud
- M Andreani Stefano
- M Ashoush Fouad
- M Bajomo Oreoluwa
- M Blundell Chris
- M Cicerchia Pierfranco
- M Connolly Tara
- M Diez-Alonso Manuel
- M Dur\ue1n-Mu\uf1oz-Cruzado (Hospital Universitario Virgen del Rocio) Virginia
- M Emslie Katy
- M Harrison Ewen
- M Holbrook Charlotte
- M Isolani Simone
- M Keatley James
- M Leite-Moreira Andr\ue9
- M Mithany Reda H
- M Mohan Helen
- M Mohan Helen
- M Monteiro Joana
- M Morgom (Tripoli Central Hospital) Marwa
- M Muguerza Jose
- M Nunes Quentin
- M Nygaard Rachel
- M Omar Aneel Bhangu Omar
- M Philp Matthew
- M Pollok Joerg
- M Rooney Siobhan
- M Sampietro Gianluca
- M Sewards Joseph
- M Tang Alethea
- M Trout Isobel
- M Walters (Harborview Medical Center Andrew
- MA Kaafarani Haytham
- MA Kaafarani Haytham
- MA Kaafarani Haytham
- Maarten van Heinsbergen (VieCuri Medisch Centrum) Joop Konsten
- Mabrouk Islam
- Macchi Alberto
- MacDonald Luisa
- Machairas (Royal Free Hospital) Nikolaos
- Madonini Marco
- Madrid)
- Madrid)
- Magalh\ue3es Maia Mariana
- Magne Augestad Knut
- Magowan Drew
- Maha H Haqqani (Boston Medical Center) Frederick T Drake
- Maisonneuve Emeline
- Majkowska Agata
- Majkowski (Northern General Hospital Lawrence
- Mak (Queen Elizabeth Hospital Birmingham) Jason
- Malabarba Stefano
- Malerba Michele
- Maninder Kalkat 7
- Mannan Syed
- Manson Joanna
- Mansuri Ahmer
- Mantoglu (Sakarya University Research and Educational Hospital) Baris
- Manu Nichola
- Manzoni 56 Via
- Maqsood Afnan
- Marano Alessandra
- Marchbank Adrian
- Marcos-Santos Pablo
- Marinos Kouris (Buckinghamshire Healthcare NHS Trust) Spyros
- Marqueta De Salas Maria
- Marrano Enrico
- Mart\uedn-Rom\ue1n Lorena
- Mart\uednez P\ue9rez Carolina
- Mart\uednez-dePaz Fernando
- Martel Lozano Saida
- Martin (St Mary's Hospital) Guy
- Martin Emmeline
- Martin Janet
- Martin-Albo Lorena
- Martine Uittenbogaart (M\ue1xima Medical Center) Wouter KG Leclercq
- Martinelli Fabio
- Martinez-German Antonio
- Martinez-Pinedo Carlos
- Martins Ricardo
- Marwan Hisham
- Marzi Federica
- MAS Baig Mirza
- Mateos-Sierra (Hospital General Universitario Gregorio Mara\uf1\uf3n) Olga
- Mater Studiorum University of Bologna) Alma
- Mathieu (CHU Besan\ue7on) Pierre
- Matute-Najarro Maria-Soledad
- Maw Andrew
- Mazingi Dennis
- Mazzaferro (Fondazione IRCCS Istituto Nazionale dei Tumori Vincenzo
- McCanny (Antrim Area Hospital) Andrew
- McKenzie Katherine
- McLarty (Northumbria NHS Hospital Trust) Nicola
- McPherson Iain
- Medina Esther
- Mediratta Saniya
- Medone Marzia
- Mehra (Guy's and St Thomas\u2019 NHS Foundation Trust) Gautam
- Mele Simone
- Melero-Cort\ue9s Lidia
- Melody Baeza (Morales Meseguer University Hospital) Jos\ue9 Aguilar
- Mendon\ue7a Ata\uedde Gomes Gustavo
- Mendoza-Moreno Fernando
- Meneghini Simona
- Merate
- Mercante Giuseppe
- Merdrignac (Rennes University Hospital) Aude
- Metallidis Symeon
- Michel (Pinderfields Hospital) Martin
- Migliore Marco
- Milan)
- Milan)
- Milan)
- Miller Douglas
- Minaya- Bravo Ana
- Minaya-Bravo Ana
- Minaya-Bravo Ana
- Minaya-Bravo Ana
- Mingoli Andrea
- Minto Gary
- Mirabella Antonello
- Misra Nikhil
- Mitrasinovic Stefan
- Miu Victor
- Moawad (Royal Victoria Hospital) Nader
- Mochet Sylvie
- Modabber Ali
- Mohammad Adam
- Mohan Midhun
- Moliner-S\ue1nchez Carmen
- Mondov\uec)
- Mongelli Francesco
- Monteleone (Ospedale San Leopoldo Mandic Michela
- Montuori Mauro
- Moore Rachel
- Mora-Guzm\ue1n (Hospital Santa B\ue1rbara) Ismael
- Morales Dieter
- Morales Xavier
- Morelli Luca
- Morelli Lucia
- Morgan Richard
- Morris Chris
- Mortini Pietro
- Mosca Angelo
- Moszkowicz David
- Moszkowicz David
- Motter Dema
- Moug Susan
- Mukherjee Samrat
- Munoz Rivas Ana
- Murcia)
- N Bence Matthew
- N Hopkinson David
- N Mashbari Hassan
- N Mashbari Hassan
- N Mashbari Hassan
- N Naumann David
- N Rao Jagan
- N Townshend David
- N\ufa\uf1ez Jordi
- Najdy Manhal
- Nakas (Glenfield Hospital Apostolos
- Namazov Ilgar
- Naredla Pradyumna
- Nasef Emmhamed
- Nassa Heeam
- Nath Rahul
- Navarro-S\ue1nchez Antonio
- Nazarian (Bupa Cromwell Hospital) Scarlet
- Neal Bhutiani (University of Louisville Hospital and Norton Hospital) Robert CG Martin
- Negri Giampiero
- Nehra Deepika
- Neil-Dwyer Jason
- Nepogodiev Dmitri
- Nepogodiev Dmitri
- Nepogodiev Dmitri
- Neri Jacopo
- Netherlands: Suzanne S Gisbertz Mustafa R Bulugma (Zawia Teaching Hospital). Mexico: Fernando Cordera (ABC Medical Center).
- Newton (Manchester Royal Infirmary) Katy
- Nikaj (Azienda Ospedaliero Universitaria Maggiore della Carit\ue0 Herald
- Niquen Milagros
- Nobile (Azienda Ospedaliera Universitaria Integrata di Verona) Sara
- Nogueiro Jorge
- Nogues Pevidal (Royo Villanova) Ana
- Novara)
- Ntirenganya Faustin
- Nugent Michael
- O Ademuyiwa Adesoji
- O Kavanagh Dara
- O Larkin John
- Oca\uf1a Juan
- of Amsterdam University
- of Ferrara) University
- of Insubria University
- of Milan) University
- of Surgeons in Training (ASiT) Association
- of Surgery) Department
- of Washington) University
- Okafor Barbara U.
- Okechukwu Valentine
- Oliva-Mompean (Hospital Universitario Virgen Macarena) Fernando
- Oliveira Ana
- OM Abdalla Mutwakil
- Omar M Omar
- OO Ayorinde John
- Osagie-Clouard (Epsom &
- Osman (Walsall Manor Hospital) Khabab
- Ottolina Jessica
- Ourieff (Mount Sinai Hospital) Jared
- Outani Oumaima
- Oyewole Bankole
- P Arnaud Alexis
- P Arnaud Alexis
- P Arnaud Alexis
- P Baker Markus
- P Belgaumkar Ajay
- P Boddy Alexander
- P Duffy (Nottingham City Hospital) John
- P Evans Jonathan
- P Hazelton Joshua
- P Jones Andrew
- P Jones Robert
- P Joyce Doireann
- P Kisiel Aaron
- P Pezzuto Anna
- P Singh Rabindra
- P\ue9rez-Gonz\ue1lez Marta
- P\ue9rez-Saborido Baltasar
- Pacheco-Sanchez David
- Padilla-Valverde (Hospital General Universitario De Ciudad Real) David
- Pai (Hammersmith Hospital) Madhava
- Paiella Salvatore
- Paisley (Brighton and Sussex NHS Trust Samuel
- Palermo)
- Palini Gianmarco
- Palmeri Matteo
- Parente Alessandro
- Parlanti Daniele
- Parmar Chetan
- Pascual Angela
- Pata Francesco
- Pata Francesco
- Patel Mahul
- Pathak Abhijit
- Patil Sangram
- Pattyn Piet
- Peckham- Cooper Adam
- Pedram Panahi (University Hospitals Plymouth NHS Trust) Mariam Rela
- Pedrazzani Corrado
- Pellino Gianluca
- Pereira Andr\ue9
- Pereira-Neves Ant\uf3nio
- Perez-Diaz Md
- Perivoliotis (General University Hospital of Larissa) Konstantinos
- Perkins Clare
- Perotto (CHU Saint Etienne) Ornella
- Perra Teresa
- Petrone Patrizio
- Phenix George
- Piacenza)
- Picazo Sara
- Picon-Rodriguez Rafael
- Piloni Martina
- Pingarr\uf3n-Mart\uedn Lorena
- Pinotti Enrico
- Pizzini Paolo
- PM de Vries Jean-Paul
- Pockney Peter
- Podolsky Dina
- Poggioli Gilberto
- Pompili Cecilia
- Pontari Michael
- Porcu Alberto
- Portugal: Hugo Santos-Sousa Pakistan: Mariyah Anwer (Jinnah postgraduate medical center).
- Potter (Royal Bournemouth Hospital) Ryan
- Price Claire
- Prita Daliya 8
- Pruvot (Lille University Hospital) Fran\ue7ois-Ren\ue9
- PTSurg ItSURG
- Pujol-Muncunill Roger
- Puppo Andrea
- Q Mehdi (University of Texas Medical Branch) Mohammad
- Quante Markus
- Quintana-Villamandos Bego\uf1a
- Qureshi Ali
- R Burke Joshua
- R Davidson Brian
- R Dixon Jan
- R Fretwell Kenneth
- R Gujjuri Rohan
- R Gujjuri Rohan
- R Kowal Mikolaj
- R O\u2019Neill John
- R Sarma Diwakar
- R Spalding Duncan
- R Springford Laurie
- Rachel Baumber (Royal National Orthopaedic Hospital) James T Parry
- Radenkovic Dejan
- Rahman Saad (Medway Maritime Hospital) Abdel
- Rakvin Ivan
- Ramallo-Sol\ueds Irene
- Ramcharan Sean
- Ramos Diego
- Ramos-Bonilla Antonio
- Ramos-De la Medina Antonio
- Ramzi Joussi
- Rathinam Sridhar
- Rausa Emanuele
- Ravaioli Matteo
- Ravindran Sharanya
- Raymond (Royal Lancaster Infirmary) Thomas
- Razik Aisha
- Redfern (Furness General Hospital) Jennifer
- Reguera-Rosal Julio
- Rey-Biel Juan
- Rey-Valcarcel Cristina
- RG Sheel Andrea
- Ribolla Marta
- Richards Tomos
- Richmond (University of Maryland Medical Center) Michael
- Righini (Ospedale del Delta Erminio
- Rio-Gomez Javier
- Riuniti Villa Sofia-Cervello Ospedali
- Riyat Harjoat
- Rizvi Sana
- Roberts Keith
- Roberts Matthew
- Robertson (University Hospitals Coventry and Warwickshire) Stuart
- Robertson (University of Arkansas for Medical Sciences) Ronald
- Robin-Valle Alvaro
- Rochon Melissa
- Rojo Mikel
- Rolli Luigi
- Romano Silvio
- Rome)
- Romford)
- Ross Elizabeth
- Ross Howard
- Rottoli Matteo
- Royal Hospital) Princess
- Ruiz (Hospital General Universitario Reina Sof\ueda Miguel
- Ruiz- Grande Fernando
- Ruiz-Martin (Rey Juan Carlos University Hospital) Irene
- Ruiz-Soriano (Hospital Cl\uednico Universitario de Valladolid) Mar\ueda
- Ruzzenente Andrea
- Ryska Ondrej
- S Abdelaal (Alexandria Main University Hospital) Ahmed
- S Al Maadany Faraj
- S Faria Carlos
- S Hammond John
- S Hossain Fahad
- S Jeyaretna Deva
- S Jones Conor
- S Khan (Queen Alexandra Hospital) Jim
- S Moura Francisco
- S Ng-Kamstra Joshua
- S Sica Giuseppe
- S Tamimy Muhammad
- S Wadley Martin
- S\ue1nchez- Arteaga Alejandro
- SA Taher Ahmed
- Saez Carlos
- Sahnan Kapil
- Sahni Arun
- Salim Ali
- Salvia Roberto
- Sammarco Giuseppe
- Sampaio-Alves Mafalda
- San Miguel-Mendez Carlos
- Sanchez del Pueblo Cristina
- Sanchez-Fuentes Maria-Nieves
- Sanchez-Pelaez Daniel
- Sanchez-Perez Coral
- Sanchez-Rubio Maria
- Sancho-Muriel Jorge
- Sanchon Fructuoso Lorena
- Sanders Julie
- Santero-Ramirez Maria-Pilar
- Santora Thomas
- Santoro Antonio
- Santos Irene
- Sapienza Paolo
- Sartarelli (Sant\u2019Orsola Hospital Lodovico
- Sarveswaran Janahan
- Sasia Diego
- Sassari) A. O. U.
- Saudemont Alain
- Saudi-Moro Sef
- Saxena Dolly
- Saxena Shobhit
- Sayasneh Ahmad
- Scalabre Aurelien
- Schache Andrew
- Schiavina Riccardo
- Schineis (Charit\ue9 University Medicine Christian
- Schreckenbach Teresa
- Scorza Antonella
- Scott Lucy
- Seegert (ProMedica Toledo Hospital) Sara
- Seguin-Givelet Agathe
- Senent-Boza Ana
- Serrano Gonz\ue1lez Javier
- Sette Laghi Asst
- Seymour Keith
- Shabana Amanda
- Shah (The Whittington Hospital) Sujay
- Shah Jigar
- Shah Karishma
- Shah Preena
- Shakir Taner
- Shalaby (Mansoura University Hospital) Mostafa
- Shankar (Oxford University Hospitals NHS Foundation Trust Sushma
- Shaw Richard
- Sheffield)
- Shehata Sameh
- Shelley Hwang E.
- Shen Ban Vin
- Shenfine Amy
- Sheridan Kelda
- Sherief Ahmed
- Sherif Mohamed
- Shinkwin Michael
- Shu Sebastian
- Siaw-Acheampong Kwabena
- Sileri (San Raffaele Scientific Institute Pierpaolo
- Singh Abhinav
- Singh Shailendra
- Sinha Sanjay
- Siragusa (Policlinico Tor Vergata Hospital Leandro
- Sivaprakasam Rajesh
- Sivayoganathan Sriharan
- SJ Ledesma Frances
- Smillie Robert
- Smith (Countess of Chester Hospital) Claire
- Smith Andrew
- Smith Christopher
- Sochorova (Royal Liverpool University Hospital) Dana
- Society of Coloproctology (ESCP) European
- Society of Colorectal Surgery (SICCR) Italian
- Soggiu Fiammetta
- Sohrabi (St Bartholomew's Hospital) Catrin
- Sohrabi (Whipps Cross University Hospital) Catrin
- Sohrabi Catrin
- Solari (Royal Gwent Hospital) Francesca
- Solli Piergiorgio
- Soreide Kjetil
- Soto Montesinos Cristina
- SpainSurg
- Spinelli Antonino
- Spinelli Antonino
- Spoletini (Sant'Eugenio Hospital) Domenico
- Spriano Giuseppe
- Sravanam Sanskrithi
- Ssentongo (Pennsylvania State University) Paddy
- Stanger Sophie
- Stavroulias Dionisios
- Steel (Sunderland Royal Hospital) Ben
- Stella Marco
- Stewart Robbie
- Stringer Sally
- Sudan: Osman M Ali Elima P Cagigal- Ortega (Hospital Universitario Severo Ochoa).
- Sulen Nina
- Sundar Sudha
- Sundhu (Aintree University Hospital) Matthew
- Surgical Research Collaborative (ISRC) Irish
- Suri (University of California Davis Health Avni
- Swansea)
- Switzerland: Dimitri Christoforidis Ali A Ali karar (Al-rajhi).
- Syed Arooj
- Szatmary Peter
- T Colonna Emily
- T Enjuto Diego
- T Montella (Azienda Unit\ue0 Sanitaria Locale-IRCCS di Reggio Emilia) Maria
- TA Neely David
- Tabiri Stephen
- Tadross Daniel
- Taglietti Lucio
- Tansey (Princess Alexandra Hospital) Rosamond
- Tartaglia Dario
- Tawheed (Endemic Medicine Department Ahmed
- Tayeh Salim
- Testa Valentina
- Tewari Nilanjana
- Thoenissen Philipp
- Thomas (Worcestershire Acute Hospitals NHS Trust) Kane
- Thrush Jessica
- Tierney Sean
- Tiwari Abhinav
- Tobias Teles (Hospital de Cascais - Dr. Jos\ue9 de Almeida) Pedro A Serralheiro
- Toledo Enrique
- Tonini Valeria
- Torkington Jared
- Torzilli Guido
- Totty Joshua
- Tousidonis Manuel
- Townend Philip
- Townsend Catherine
- Trompeter (St George's Hospital) Alex
- Trotta Francesco
- Truant St\ue9phanie
- Trujillo-D\uedaz Jeancarlos
- Tsoulfas George
- Tsoulfas Georgios
- Turco Celia
- Turkey: Volkan Ozben Georgios Peros (Kantonsspital Winterthur).
- Turrado- Rodriguez Victor
- Turri Giulia
- Tustin (Cumberland Infirmary) Harry
- Tyler Jayne
- Tzedakis Stylianos
- Tzovaras George
- Ullah Ramzan
- Unit\ue0 Sanitaria Locale di Ferrara Azienda
- United Kingdom: Richard J Davies Alp Yildiz (Yildirim Beyazit University Yenimahalle Training and Research Hospital).
- United States: John RT Monson (AdventHealth Orlando) Lavinia Onos (York Teaching Hospitals NHS Trust).
- University Hospitals NHS Trust) Nottingham
- University of Rome) Sapienza
- University) Goethe
- University) Helwan
- Urban (University of Colorado Hospital) Shane
- Urbani (Azienda Ospedaliero Universitaria San'Anna Alessia
- Usai Antonella
- V Bhavaraju Avi
- V Comini Lara
- V Feo Carlo
- V Marino Marco
- V Shaw Abigail
- V\ue1zquez- Fern\ue1ndez Andrea
- Vaccarella (Azienda Ospedaliera Gianpaolo
- Valdes- Hernandez Javier
- Valsecchi Luca
- Vashisht Rajiv
- VCO) Asl
- Venkatesan (Glan Clwyd Hospital) Gowtham
- Vera-Mansilla Cristina
- Vergari (Ospedali Riuniti di Ancona) Roberto
- Vescio (University 'Magna Graecia' of Catanzaro) Giuseppina
- Vidya Raghavan
- Vieira (Centro Hospital Universit\ue1rio S\ue3oJo\ue3o) Paula
- Vijay Vardhini
- Vimalachandran Dale
- Vimalachandran Dale
- Violante Tommaso
- Vovola Fernanda
- Vulliamy Paul
- W Endorf (Hennepin Healthcare) Frederick
- W Etchill Eric
- W L\uf6ffler Markus
- W L\uf6ffler Markus
- Wall Rosemary
- Wallwork Kate
- Ward Alex
- Warwick (University Hospital Southampton) David
- Waseem Saima
- Weaver Helen
- Wells Fiona
- Wen Jiaxin
- West Raha
- Whitehall Emma
- Wild Laura
- Wilkins Alex
- Williams Gethin
- Williams Matthew
- Winnand (University Hospital Aachen) Philipp
- Wong (Addenbrooke's Hospital) Ken
- Worku (Queen\u2019s Medical Centre Dawit
- Wright Naomi
- WS Ho (Leeds Teaching Hospitals NHS Trust Michael
- WT Ngu Albert
- y Cajal) Cristina Cerro (Hospital Universitario Ram\uf3n
- Y Oo (Department of Cardiothoracic Surgery Aung
- y Polit\ue9cnico La Fe) Blas Flor (Hospital Universitario
- Y van der Plas Willemijn
- Yalamanchili Seema
- Yershov (South Warwickshire NHS Foundation Trust) Danylo
- Young Richard
- Yousra Ahmed (Portsmouth Hospital NHS Trust) Simon Toh
- Yurttas Can
- Zadegan Frederic
- Zafar (Northwick Park Hospital) Noman
- Zakaria Rasheed
- Zambon Martina
- Zanini Nicola
- ZE Durst Alexander
- Zerbib Philippe
- Zonta (Ospedale San Biagio Sandro
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2020
- Field of 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 1·28â2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65â3·22], p\textless0·0001), American Society of Anesthesiologists grades 3â5 versus grades 1â2 (2·35 [1·57â3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01â2·39], p=0·046), emergency versus elective surgery (1·67 [1·06â2·63], p=0·026), and major versus minor surgery (1·52 [1·01â2·31], 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
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado HĂ©ctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
- Ajiya Abdulrazak
- Akeel Nouf
- Akin Emrah
- Akinajo Opeyemi
- Akinyemi Tosin
- Akrida Ioanna
- Aktokmakyan Talar Vartanoglu
- Akwaisah Ayoub
- Al Bettar Osama
- Al-Badawi Ismail A.
- Al-Juaifari Maytham
- Al-Khyatt Waleed
- Al-Mallah Abdullah
- Al-Nusairi Ahmed
- Al-Saadi Nina
- Al-Sayaghi Khaled
- Al-Shaiji Tariq
- Al-Shehari Mohammed
- Al-Touny Aiman
- Al-Touny Shimaa A.
- Aladawi Omar
- Aladna Abdallah
- Alali Mahmoud
- Alam Mahmood
- Alam Mohammed Shadrul
- Alarabi Rehab
- Alawneh Yazan
- Alayande Barnabas
- Albanese Erminia
- Albayadi Eslam
- Albdour Maram
- Alconchel Felipe
- Alderazi Amer
- Alegbeleye Bamidele
- Alekberli Tural
- Alemu Misganaw Alemu Adimass
- Alexander Philip
- Alfieri Alex
- Algahtany Khaled
- Algarni Kamal
- Alhamad Ameen
- Alhamid Mohammad
- Alharmi Rawan A. Rahman
- Alharthi Mohammed
- Alhazmi Barrag
- Ali Mohamed Shafi Mahboob
- Ali Stephen
- Alibrahim Hidar
- Aljaaly Hattan
- Aljaiuossi Anas
- Aljanadi Firas
- Aljiffry Murad
- Aljirdabi Noof
- Alkahlan Mohammed
- Alkhalifa Elmustafa
- Alkhatib Sondos
- Alkhatieb Maram
- Allan Anna
- Almarshad Felwa
- Almgla Naser
- Almhimid Ali
- Almiqlash Bushray
- Almoshantaf Mohammad Badr
- Almutairi Abdulmjeed
- Alnsour Abed Alfattah Mahmoud
- Alobied Majd
- Alomar Osama
- Alonso JesĂșs AarĂłn MartĂnez
- Alonso Manuel Diez
- Alonso Nestor Fabian Pedraza
- Alonso Veronica
- Alqallaf Abdullah
- Alqaseer Asma
- Alrayes Bourhan
- Alsefri Maryam
- Alser Osaid
- Alsharif Mohammed
- Alsori Mohamed
- Altaf Abdulmalik
- Altinel Yuksel
- Altiner Saygin
- Altouny Ahmad
- Altun Demet
- Alvarez Natalia
- Alvarez-Lozada Luis Adrian
- Alvi Abdul
- Alwael Athari
- Alwash Mohammed
- Alyami Ziyad
- Alyousef Mohammed
- Alzahrani Saud
- Alzerwi Nasser
- Amin Shivang
- Amir Mohammed
- Ammar Ahmed Siddique
- Ammendola Michele
- Amores Remedios Revilla
- Amrayev Sultan
- Anastasiadou Sofia
- Ancans Guntis
- Anderson Caroline
- Andreani Lorenzo
- Andreotti Dario
- Andreuccetti Jacopo
- Andrianakis Alexandros
- Andro Christophe
- Anesi Alexandre
- Angamuthu Stephen
- Angeles Martina Aida
- Angelico Roberta
- Angelis Fragkiskos
- Angelou Dimitrios
- Angelou Kyveli
- Angulo Victor Pinto
- Anjum Arfa
- Anjum Muhammad Ayyub
- Annicchiarico Alfredo
- Anoldo Pietro
- Ansaloni Luca
- Anthoulakis Christos
- Antonelli Amedeo
- Anwar Mohamed
- Anwar Sumadi Lukman
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- Gmati Aimen
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- Ingallinella Sara
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- Katsura Morihiro
- Kauppila Joonas H
- Kaur Amanjot
- Kausar Nabila
- Kavalakat Alfie
- Kavanagh Marcel MarjanoviÄ
- Kazan Ozgur
- Kealey Joshua
- Kebede Ephrem
- Kedwany Ahmed
- Kelly Michael
- Ken-Amoah Sebastian
- Kenington Cleo
- Kennerton A.S.
- Kent Alistair J
- Keramati Mohammad Reza
- Kethy Fagnon
- Keçi Laura
- Khalifa Ahmad
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- Kinnair Anthony
- Kirac Iva
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- KoĆĄir Jurij AleĆĄ
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- Kroon Hidde M.
- Kruse Philippe
- Kryzauskas Marius
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- Kumar Calvin
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- Kuriyama Akira
- Kusuma Venkata Ramana Murthy
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- Köglberger Paul
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- Königsrainer Ingmar
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- Laborde Mario Mella
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- Latif Ejaz
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- Lawal Taiwo Akeem
- Lazarides Alexander
- Lazarou Lazaros
- Lebe Moritz
- Lechuga Daniel Garay
- Ledda Virginia
- Lederhuber Hans
- Lee Susan
- Lenzi Riccardo
- Leon-Andrino Alejandro
- Leonard Laura
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- Lohmann Tibor Karl
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- Lopez Paloma Rodriguez
- Losada Manuel
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- Lyra Humberto Fenner
- Mabood Waleed
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- Maffuz-Aziz Antonio
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- Magnone Stefano
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- Maguire Patrick J.
- MaheÄiÄ Tina TomiÄ
- Mahmood Fahad
- Mahmoud Abdelrahman
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- Malagnino Alessia
- Malek Bouhani
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- Malik Sobia
- Mallick Rebecca
- Mallmann Christoph
- Mallmann Michael R.
- Mambrilla Sara
- Manangi Mallikarjuna
- Manesh Hassan Fatemi
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- Mangi Ali
- Maniaci Antonino
- Manickavasagam Jaiganesh
- Manigrasso Michele
- Manjula S.
- Mannan Syed
- Mantziari Styliani
- MaquilĂłn Alejandra Jara
- Marafante Chiara
- Marano Luigi
- Marei Mahmoud
- Mariani NicolĂČ Maria
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- Marriott Paul
- Marson Ben
- Martellucci Jacopo
- Martin Benjamin
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- Martinelli Fabio
- Martinez-Leo Bruno
- Martinez-Mier Gustavo
- Martinez-Perez Carolina
- Martinez-Said Hector
- Martins Ana
- Martins Claudia Pinto
- Martins Paulo N.
- MartĂnez Daniel FernĂĄndez
- MartĂnez Eunate Ganuza
- MartĂnez VerĂłnica MartĂn
- MartĂnez-SĂĄnchez Marta Isabel
- Masciello Fabrizio
- Masri Ruqaya
- Massaguer Clara
- Massoud John
- Mata Javier
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- Materazzo Marco
- Mathew Ryan
- Matos Leandro
- Matos Philomena Alice Wawer
- Matthews Emily
- Mauriello Claudio
- Maurus Christine
- Mayer Horacio F.
- Mayo-Yåñez Miguel
- Mazzarella Gennaro
- Mbodi Langanani
- Mbwele Bernard
- McAleer Stephen
- McCarthy Claire
- McGrath John
- McKay Joseph
- McLean Aaron Lawson
- McLeish Bethan
- McPherson Duncan
- Meara John G.
- Meead Adullah
- Mehraj Asif
- Meilak Joseph
- Meleiro Hugo
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- Meneghini Simona
- Mengesha Mengistu G.
- Menna Maria Paola
- Menon Arun
- Meola Antonio
- Merayo Marta
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- Mesina Cristian
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- Migliore Marcello
- Migliorelli Federico
- Mihanovic Jakov
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- Milella Oronzo
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- Millward Christopher Paul
- Mingoli Andrea
- Mirica Radu Mihail
- Mishra Brijesh
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- Mittal Abhishek
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- Modabber Ali
- Modolo Maria Marta
- Mohamed Ahmed Mohamed Ibrahim
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- Mohamedahmed Ali Yasen Y.
- Mohammed Alhassan Datti
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- Mostafa Badr
- Motas Natalia
- Mouawad Nicolas
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- Mousli Alaa
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- Muhaisen Mo'Nes
- Muhammad Abubakar Bala
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- Musadaq Muhammad
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- Mvukiyehe Jean Paul
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- Myrelid Par
- Myriokefalitaki Eva
- MĂ©ndez Patricia Serrano
- Nabil Fatma
- Nachelleh Emmanuel Aadereyir
- Nacion Aeris Jane D.
- Nadi Khaldoun
- Naegele Felix
- Naga Hani
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- Nahm Christopher
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- Nakano Luis
- Nanjiani Deedar
- Nankivell Paul
- Naranjo Eddy P. Lincango
- Narayanan Vairavan
- Nardo Bruno
- Narvaez-Rojas Alexis Rafael
- Nassar Mahmoud A.
- Nasser Sara
- Nastos Constantinos
- Natale Joseph
- Nataraja Ramesh
- Nathan Arjun
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- Navarrete-PeĂłn Alberto
- Navarro-Barrios Alvaro
- Nazer Ahmed
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- Negoi Ionut
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- Nenna Antonio
- Nepogodiev Dmitri
- Nestor Claire
- Nevins Edward J.
- Newman Samuel
- Ngaserin Sabrina
- Nicholson Gary
- Niewiera Marc
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- Nikolouzakis Taxiarchis
- Nikolovska Bisera
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- Nissi Evelyn R.
- Nitschke Christine
- Njokanma Iloba
- Noel Colin
- Nolte Peter
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- Novysedlåk René
- Ntalouka Maria P.
- Ntirenganya Faustin
- Nugur Ashwani
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- Nwafor Ikechuwu
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- NĂșñez Bernardo
- O'Connell Robert Michael
- O'Connor Alexander
- O'Dwyer Marliza
- O'Riordan James
- Odai Emeka Danielson
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- Oktseloglou Vlasios
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- Olori Samson
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- Osborn Tamara
- Oshodi Yusuf
- Osman Hany
- Osman Osama Saeed
- Osterhoff Georg
- Othman Ahmad Faidzal
- Othman Amani Alsayd Abdulsalam
- Othman Rema
- Otify Esraa
- Otokwala Job
- Oung Thida
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- Ozkan Omer Faruk
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- Paal Peter
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- Papavasiliou Kyriakos
- Paranjape Charudutt
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- Paraskevopoulos Konstantinos
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- Park James
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- Pascale Marco Maria
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- Persad Amit
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- Pessaux Patrick
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- Petrucciani NiccolĂČ
- Petruzzi Gerardo
- Pettigrove K.L.
- Phillips Jonathan
- Picardi Biagio
- Picchetto Andrea
- Picciariello Arcangelo
- Picciochi Maria
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- Pieteris Linas
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- Pilkington Isobel
- Pillerstorff Robert
- Pineda Ana MejĂa
- Pinkney Thomas
- Pinney L.
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- Piozzi Guglielmo NiccolĂČ
- Pira Biagia La
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- Pirozzi Brunella Maria
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- Pitcher Meron
- Pitoni Sara
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- Podda Mauro
- Poillucci Gaetano
- Pollok Joerg Matthias
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- Potten Stephanie
- Pournaras Dimitri
- Power Nicholas
- Prada Carlos
- Pradhan Akhilesh
- Pramesh C.S.
- Prats Milagros Carrasco
- Prieto Mikel
- PrijoviÄ NebojĆĄa
- Prodromidou Anastasia
- Proud David
- Prucher Gian Marco
- Prusty Lydia
- Pu Jingya Jane
- Pucher Philip
- Punjabi Prakash P
- Puri Ajay
- Purich Kieran
- PĂ©rez Beatriz GĂłmez
- PĂ©rez-BertĂłlez Sonia
- Qader Kawthar
- Qin Kirby R.
- Quadri Oladeji
- Quaresima Silvia
- Querney Jill
- Quintana-Villamandos Begoña
- Quzli Ahmad
- Rabie Mohamed
- Racine Michaël
- Radhakrishnan Ajay
- Radin Zorana
- RadivojeviÄ Renata Curic
- Radulescu Raluca Bievel
- Radwan Asmaa
- Ragozzino Roberta
- Rahman Atiqur
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- Rai Lajpat
- Raimondo Diego
- Raja Anand
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- Rajendram Rajkumar
- Raji Hadijat Olaide
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- Rammohan Ashwin
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- Rampersad Lisa
- Ramzanali Shireen
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- Rani Jyotsna
- Ranucci Maria Chiara
- Raphael Marie-Claire
- Raptis Dimitri Aristotle
- Rasheed Aqsa
- Rashid Isbah
- Ratto Carlo
- Rauf Umme Habiba Abdul
- Raurich-Leandro Jordi
- Rausa Emanuele
- Raut Chandrajit
- Raut Monish
- Ravindra Raevin
- Raymond Thomas
- Rayner Anthony
- Raza Muhammad Asif
- Recinos Gustavo
- Recker Florian
- Recordare Alfonso
- Redondo Nuria Villacé
- Redondo Silvia Villacé
- Reemst Peter
- Rega Daniela
- Regan Azel
- Reicher Marcello
- Reichert Martin
- Reid Jeremy
- Reilly John-Joe
- Reim Daniel
- Reis Igor
- Rela Mariam
- Render Luke
- Reyes Jeryl Anne Silvia
- Rezende Ricardo Fernandes
- Rhomberg Thomas
- Ribeiro JoĂŁo
- Riccetti Camilla
- Richard H.
- Rickard Jennifer
- RincĂłn Natalia Andrea Rivera
- Ripollés-Melchor Javier
- Risaliti Matteo
- Risteski Toni
- Rius Malena
- Rizzo Davide
- Roberts David
- Robo Ilma
- Roditis Konstantinos
- Rodrigues Diana
- Rodrigues Gabriel
- Rodrigues Sara Castanheira
- Rodriguez H. Alejandro
- Rodriguez Magdiel
- Rodriguez-Lopez Mario
- RodrĂguez Lorena Varela
- Rokohl Alexander Christopher
- Roland Christina L
- Rolinger Jens
- Romano Angela
- Romano Maurizio
- Romanzi Andrea
- Romera Jorge Sanz
- Romero Patricia
- Ronellenfitsch Ulrich
- Ros Emilio Peña
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- Ross Samuel
- Rossaak Jeremy
- Rottoli Matteo
- Rotunno Giuseppe
- Roux Simon Le
- Rowe Christopher
- Rudic Milan
- Ruggiero Silvia
- Ruiz-MarĂn Miguel
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- Russo Iris Shari
- Ryalino Christopher
- Ryan James
- Ryan Ăanna
- Saad Rema
- Saaid Rahmah
- Sabbagh Abdulrahman J.
- Sabella Danielle
- Sablotzki Armin
- Sacdalan Marie Dione
- Sachdev Gaurav
- Sachdeva Ashwin
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- Saed Abdel
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- Saeed Umar
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- Sagnotta Andrea
- Saguil Esther
- Sahni Arun
- Sahu Mo
- Saibene Alberto Maria
- Saif Areeba
- Sakakushev Boris
- Sakhov Orazbek
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- Salah Rokeya
- Salamanca Omar
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- Salami Omotayo
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- Sanli Ahmet Necati
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- Santoshi John Ashutosh
- Santric Veljko
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- Sarjanoja Elise
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- Sasia Diego
- Sasireka Veerasamy
- Satchithanantham Vinojan
- Satoskar Savni
- Sayed A. Emad
- Sayyed Raza
- Scabini Stefano
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- Schröder Lars
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- Scopelliti Michele
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- Seenivasagam Rajkumar Kottayasamy
- Segalini Edoardo
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- Seglenieks Richard
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- Seiwerth Ingmar
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- Semple Abigail
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- Sethi Aman
- Seyfried Steffen
- Seyi-Olajide Justina
- SeÄan Tomislav
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- Shaban Naseebah
- Shaddad Ebrahim
- Shaerf Daniel
- Shah Faaiz Ali
- Shah Hemina
- Shah Jaffer
- Shah Karishma
- Shah Pritik A
- Shah Vinay
- Shaikh Shafaque
- Shalaby Mostafa
- Shalhoub Joseph
- Shamim Shahzad
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- Sherif Ahmed Elshawadfy
- Shiban Ehab
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- Shirazi Ahmed
- Shiwani Haaris
- Shmukler Daniel
- Shokor Muntaser Abu
- Sholadoye Tunde T.
- Shoukrie Shoukrie I. M.
- Shrestha Rashmit
- Siboe Mark
- Sica Giuseppe
- Siddig Esra
- Siddiqui M. Tayyab
- Sidiropoulos Theodoros
- Sievers Denise
- Sigamoney Kohila
- Silvestri Vania
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- SimÔes Joana Filipa Ferreira
- Singer Georg
- Singh Abhinav
- Singh Baljit
- Singh Kathryn
- Singh Rajdeep
- Singh Tanveer
- Sinnerton Robert
- Siragusa Leandro
- Sivaprakasam Rajesh
- Skipworth Richard Je
- Slavchev Mihail
- Sleem Adham
- Smati Ismail
- Smelt Jeremy
- Smith A.
- Smolle-Juettner Freyja-Maria
- Sodhai Vivek
- Sofi Khalid
- Sohrabi Catrin
- Soibiharry Adaiah
- Sokolov Manol
- Solaini Leonardo
- Sole Oriol Martin
- Sole-Sedeno Josep M.
- Soljic Martina
- Solli Piergiorgio
- Soon Wai Cheong
- Sorbi Flavia
- Sotiropoulou Maria
- Sotudeh Mohadeseh
- Souadka Amine
- Soucheiron Maria Coronas
- Soytas Mustafa
- Sozzi Giulio
- Sparavigna Marco
- Spartalis Michael
- Spellar Kayleigh
- Spiers Harry V. M.
- Spina Alfio
- Spriano Giuseppe
- Squiers John
- Stabler Robert
- Stamatakis Emmanouil
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- Starr Nichole
- Stather Philip
- Stevens Sean
- Stevenson Andrew
- Stewart Grant D.
- Stijns Jasper
- Stogowski Piotr Tomasz
- Stoleriu Mircea Gabriel
- Stoyanov Vladislav
- Street John
- Strotmann Johanna Josefine
- Stroumpoulis Konstantinos
- Su Yu-Xiong
- Suarez Sara Busto
- Subramani Yamini
- Subramaniam Sentilnathan
- Sue-Chue-Lam Colin
- Suer Muhammed Salih
- Sulaiman Bilal
- Sultania Mahesh
- Sundarraju Shalini
- Sungurtekin Hulya
- Suresh Sreelakshmi
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- Zarif Pierre
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- Zehnder Philipp
- Zenger Serkan
- Zenha HorĂĄcio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ăvila Clara Castro
- ĂlgĂ„ Andreas
- Ăakici Mehmet Ăaǧlar
- Ăelik Enes
- Ăelik Meryem Nur
- Ăzçay Necdet
- Ćevik HĂŒsnĂŒ
- Ć antak Goran
- Ć imko KristiĂĄn
- ĆœateckĂœ Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and lowâmiddle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of âsingle-useâ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for lowâmiddle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both highâ and lowâmiddleâincome countries
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The Potential for Treatment Shortening With Higher Rifampicin Doses: Relating Drug Exposure to Treatment Response in Patients With Pulmonary Tuberculosis.
- Author
- Publication venue
- eScholarship, University of California
- Publication date
- 01/06/2018
- Field of study
BackgroundTuberculosis remains a huge public health problem and the prolonged treatment duration obstructs effective tuberculosis control. Higher rifampicin doses have been associated with better bactericidal activity, but optimal dosing is uncertain. This analysis aimed to characterize the relationship between rifampicin plasma exposure and treatment response over 6 months in a recent study investigating the potential for treatment shortening with high-dose rifampicin.MethodsData were analyzed from 336 patients with pulmonary tuberculosis (97 with pharmacokinetic data) treated with rifampicin doses of 10, 20, or 35 mg/kg. The response measure was time to stable sputum culture conversion (TSCC). We derived individual exposure metrics with a previously developed population pharmacokinetic model of rifampicin. TSCC was modeled using a parametric time-to-event approach, and a sequential exposure-response analysis was performed.ResultsHigher rifampicin exposures increased the probability of early culture conversion. No maximal limit of the effect was detected within the observed range. The expected proportion of patients with stable culture conversion on liquid medium at week 8 was predicted to increase from 39% (95% confidence interval, 37%-41%) to 55% (49%-61%), with the rifampicin area under the curve increasing from 20 to 175 mg/L·h (representative for 10 and 35 mg/kg, respectively). Other predictors of TSCC were baseline bacterial load, proportion of culture results unavailable, and substitution of ethambutol for either moxifloxacin or SQ109.ConclusionsIncreasing rifampicin exposure shortened TSCC, and the effect did not plateau, indicating that doses >35 mg/kg could be yet more effective. Optimizing rifampicin dosage while preventing toxicity is a clinical priority
The potential for treatment shortening with higher rifampicin doses:relating drug exposure to treatment response in patients with pulmonary tuberculosis
- Author
- Publication venue
- Publication date
- 18/06/2018
- Field of study
Background: Tuberculosis remains a huge public health problem and the prolonged treatment duration obstructs effective tuberculosis control. Higher rifampicin doses have been associated with better bactericidal activity, but optimal dosing is uncertain. This analysis aimed to characterize the relationship between rifampicin plasma exposure and treatment response over 6 months in a recent study investigating the potential for treatment shortening with high-dose rifampicin.Methods: Data were analyzed from 336 patients with pulmonary tuberculosis (97 with pharmacokinetic data) treated with rifampicin doses of 10, 20, or 35 mg/kg. The response measure was time to stable sputum culture conversion (TSCC). We derived individual exposure metrics with a previously developed population pharmacokinetic model of rifampicin. TSCC was modeled using a parametric time-to-event approach, and a sequential exposure-response analysis was performed.Results: Higher rifampicin exposures increased the probability of early culture conversion. No maximal limit of the effect was detected within the observed range. The expected proportion of patients with stable culture conversion on liquid medium at week 8 was predicted to increase from 39% (95% confidence interval, 37%-41%) to 55% (49%-61%), with the rifampicin area under the curve increasing from 20 to 175 mg/L·h (representative for 10 and 35 mg/kg, respectively). Other predictors of TSCC were baseline bacterial load, proportion of culture results unavailable, and substitution of ethambutol for either moxifloxacin or SQ109.Conclusions: Increasing rifampicin exposure shortened TSCC, and the effect did not plateau, indicating that doses >35 mg/kg could be yet more effective. Optimizing rifampicin dosage while preventing toxicity is a clinical priority.</p
The Potential for Treatment Shortening With Higher Rifampicin Doses: Relating Drug Exposure to Treatment Response in Patients With Pulmonary Tuberculosis
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- Aljayyoussi
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- Hesseling
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- Holford
- Holtz
- Honeyborne
- Hu
- Ian Sanne
- Janmahasatian
- Jayaram
- Johansson
- Lilian T Minja
- Lindsey H M te Brake
- Liu
- Martin J Boeree
- Michael Hoelscher
- Miller
- Norbert Heinrich
- Nyanda E Ntingiya
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- Rodney Dawson
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- Ulrika S H Simonsson
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- Wallis
- Wilkins
- World Health Organization
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- Field of study
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- Abraham Ned Australia
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- Zucchella Martino Italy
- Zuhdy Mohammad
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2021
- Field of study
Background
The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic.
Methods
The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) âdelayâ group: CRC care affected by the pandemic; 2) âno delayâ group: unaltered CRC practice.
Results
A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the âdelayâ (745, 70.9%) and âno delayâ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the âdelayâ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the âno delayâ group, while the geographical distribution was not.
Conclusions
Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospitalâs preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care
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
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- Amadigwe Rita
- Amado Andreia
- Amado FabĂola
- Amador Cristina GarcĂa
- Amanullah Nazli
- Amaral HĂ©lida Aline Tomacheski
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- Aminu Bashiru
- Amir Ahmad Suhaimi
- Ammar Ahmed Siddique
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- Ammendola Michele
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- Amorim Edgar
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- Anwar Jamal
- Anyadike Florence
- Apostolakidou Magda
- Apostolidi Eirini
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- Arabadzhiev Angel
- Arakawa Satoshi
- Arauz Jazmin
- Aravindan U
- Aremu Abdurrahman
- Aremu Isiaka
- Argawy Osama
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- Arnaoutoglou Eleni
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- Artigot Mariano
- Arturi Alessandro
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- Bamford Richard
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- Wilson Jeremy
- Wilson Kasmira
- Windels An
- Witjes Caroline
- Wong Siew Ching
- Woodward Andrew
- Wright Deborah
- Wright Jonathan
- Wu Scott
- WÄ troba Anna
- Xanthis Athanasios
- Xavier Ruben
- Xenaki Sofia
- Xynos Evangelos
- Yadav Ram Kishan
- Yadev I P
- Yague Julio
- Yakout Nadia
- 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)