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

British Local Election Database, 1889-2003

Abstract copyright UK Data Service and data collection copyright owner.This project has established a unique database of local elections results in Great Britain. The database contains data for the period of the twentieth century before wholesale local government reorganisation in 1973. It also links the existing English, Welsh and Scottish local election databases. Until now, these results had never been collated together, let alone transformed into machine-readable form. Main Topics:The part of the database comprising the twentieth century before wholesale local government reorganisation in 1973 was funded by the AHRB and contains ca.50,000 election results. These cover mainly urban areas, including English, Welsh and Scottish county boroughs between 1911 and 1972 and all London area contests in the period 1889-1971. In detail these are: County Borough Council, first year: 1911, last year: 1972, number of cases: 35678 County Council, first year: 1958, last year: 1970, number of cases: 5270 Greater London Council: first year: 1964, last year: 1970, number of cases: 96 London Borough Council: first year: 1900, last year: 1971, number of cases: 7361 London County Council: first year: 1889, last year: 1961, number of cases: 1214 The second part of the database which updates and links the existing English, Welsh and Scottish local election databases was funded by the ESRC and contains in excess of 150,000 individual local election results. In detail these are: County Council: first year: 1973, last year: 2001, number of cases: 27663 District Council: first year: 1973, last year: 2003, number of cases: 87066 Greater London Council: first year: 1973, last year: 1981, number of cases: 276 London Borough Council: first year: 1974, last year: 2002, number of cases: 5827 Metropolitan Borough Council: first year: 1973, last year: 2003, number of cases: 18995 Metropolitan County Council: first year: 1973, last year: 1981, number of cases: 1641 Unitary Authority: first year: 1974, last year: 2003, number of cases: 9879 <br

Gender mainstreaming within local planning authorities

This paper discusses the extent to which EU-derived gender mainstreaming (GM) requirements are being adopted with reference to Royal Town Planning Institute research on the situation in UK local planning authorities (LPAs). Firstly, the problem of a lack of gender perspective on planning policy is summarised. Barriers to progress are explained and the role of enablers is identified. International and European factors that resulted in GM becoming an integral component of the UK planning system are explained. The second part of the paper outlines the current extent of GM in LPAs. Although generic equalities policy is widespread, it is primarily concerned with personnel matters and there is little understanding of the impact of gender considerations on planning policy. At best there is an assumption that only policies related to women's traditional roles are affected. At worst some LPAs do not consider gender to be of any relevance to the planning process, particularly in departments where there is little social awareness and a technical and quantitative approach predominates. The methodological steps required to achieve GM that need to be applied to the planning process are summarised. Little will change unless central government gives high-level guidance on mainstreaming, and resource allocation and awareness training is increased. Cultural change is needed within the profession to enable planners to take gender seriously

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Overcoming the factors inhibiting the mainstreaming of gender into spatial planning policy in the United Kingdom

This paper investigates why gender is not being effectively mainstreamed into the work of local planning authorities in the UK. It discusses means whereby this reluctance might be overcome. Research undertaken for the Royal Town Planning Institute is drawn upon to illustrate the situation. Whilst generic mainstreaming is widespread, it predominantly relates to personnel matters and social policy issues; but there is little evidence of the mainstreaming of gender issues into spatial policy. Factors that hinder progress are identified at central and local government levels. Drawing on principles from a gender mainstreaming toolkit, developed as part of the research, key stages and components of the planning process are identified through which gender might be more successfully mainstreamed into substantive spatial policy. © 2005 The Editors of Urban Studies