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

'Islam' in Irish poetry : Thomas Moore and the early union years

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A Drone Opera

The electrifying experience of drones underscores this ambitious contemporary opera. Featuring a number of purpose-built drones, laser set design and transcendent vocals, A Drone Opera introduces audiences to the sublimely beautiful, visceral and terrifying reality of flying robots. While drones are the latest controversial addition to arsenals in military-civilian conflicts, they are also increasingly valuable tools in the frontline of emergency search, rescue and relief, in wildlife conservation and in agriculture. Enthusiastically taken up by backyard pilots, they have brought a new language to film, with aerial cinema. Yet their place in society – like that of many new technologies – is perceived through a prism of terror, disbelief, wonder and utopian fantasy. Recalling the myth of Icarus, A Drone Opera charts the wonder and potential of a magical new technology, the attendant moral panic and the hubris that sabotages the initial promise. Drawing on the secretive subculture of DIY drone-makers, researchers and hackers, A Drone Opera explores the role of drone technology and its complex and contested status in public life. Western military forces have used drones (a.k.a. Unmanned Aerial Vehicles/UAVs) to deliver thousands of strikes and targeted assassinations in Yemen, Somalia and Pakistan, extending state power beyond the point where citizens will sanction human deployment. At this juncture it is crucial to consider our relationship to UAVs and how they are used in our name. While the performance implies a critique of current political expediency, it is essentially optimistic: these amazing machines are capable of so much more than killing. To this end, A Drone Opera makes manifest the relationship between technology, violence, politics and spectacle in an opera for our time