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

Grosse Turbinenschaufeln neuer Technologie fuer umweltschonende Gasturbinen. Teilprojekt: Verhalten von Fehlstellen und kurzen Rissen Abschlussbericht GT1

As a partner in this project, Siemens Power Generation investigated the crack propagation characteristics of short cracks in CMSX4. This involved crack propagation tests under dynamic and static load, creep tests on samples of different geometries, and life calculations, with the following results: No typical short cracking behaviour was observed under dynamic loads. Short crack propagation at 950 C under static load is well described by the fracture mechanical parameter C* integral. Notched bar creep tests showed longer times to cracking for notched bars.In dem Verbundprojekt hat Siemens Power Generation u.a. die Untersuchungen von Rissausbreitungsverhalten von Kurzenrissen in CMSX4 als Hauptaufgabe bekommen. Dabei wurden Rissausbreitungsversuche unter dynamischer und statischer Belastung, Kriechversuche an Proben verschiedener Geometrie und Lebensdauerberechnung durchgefuehrt. Die wesentlichen Ergenisse sind wie folgt kurz zusammengefasst. Bei dynamischer Belastung ist kein typisches Kurzrissverhalten beobachtet worden. Kurzrissausbreitung bei 950 C unter statischer Belastung kann mit bruchmechanischer Parameter C*-Integral gut beschrieben werden. Die Kriechversuche an gekerbten Proben haben herausgefunden, dass die gekerbten Proben laengere Bruchzeit haben. (orig.)Available from TIB Hannover: F02B1268 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Bildung und Forschung, Berlin (Germany)DEGerman

Die Umstellungsinitiative - Informationsvermittlung zum Einsatz von Pestiziden beim Baumwollanbau Abschliessender Projektbericht

SIGLEAvailable from TIB Hannover: F04B671 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDeutsche Bundesstiftung Umwelt, Osnabrueck (Germany)DEGerman

Technological cooperation with the PR of China: joint research on methanol vehicles

With 5 refs., 8 tabs., 7 figs.SIGLEAvailable from TIB Hannover: FR 3479 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Der Beitrag des Anbaus herbizidresistenter Kulturpflanzen fuer die Ernaehrungssicherung in der Dritten Welt

UuStB Koeln(38)-941102298 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Asymptotic stability of traveling waves for viscous conservation laws with dispersion

SIGLEAvailable from TIB Hannover: RR 4487(2001,9) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman