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

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Great Britain Historical Database : Geographical Units and Changes, 1888-1973

<p>Abstract copyright UK Data Service and data collection copyright owner.</p>The <i>Great Britain Historical Database</i> has been assembled as part of the ongoing <i>Great Britain Historical GIS Project</i>. The project aims to trace the emergence of the north-south divide in Britain and to provide a synoptic view of the human geography of Britain at sub-county scales. Further information about the project is available at:<br> <a href=http://www.port.ac.uk/research/gbhgis/><br> http://www.port.ac.uk/research/gbhgis/</a><br> <br> The <i>Great Britain Historical GIS Project</i> has also produced digitised boundary data, which can be obtained from the UK Data Service Census Support service. Further information is available at:<br> <br> <a href="http:\\census.ukdataservice.ac.uk" title="UK Data Service Census Support">census.ukdataservice.ac.uk</a><B>Main Topics</B>:<br> The <i>Great Britain Historical Database</i> is a large database of British nineteenth and twentieth-century statistics. Where practical the referencing of spatial units has been integrated, data for different dates have been assembled into single tables.<br> <br> The <i>Great Britain Historical Database</i> currently contains :<br> <br> Statistics from the 1861 Census and the Registrar General's reports, 1851-1861<br> <br> Employment statistics from the census, 1841-1931<br> <br> Demographic statistics from the census, 1841-1931<br> <br> Mortality statistics from the Registrar General's reports, 1861-1920<br> <br> Marriage statistics from the Registrar General's reports, 1841-1870<br> <br> Trade union statistics for the Amalgamated Society of Engineers (ASE), 1851-1918<br> <br> Trade union statistics for the Amalgamated Society of Carpenters and Joiners (ASCJ), 1863-1912<br> <br> Official poor law statistics, 1859-1915 and 1919-1939<br> <br> Wage statistics, 1845-1906<br> <br> Hours of work statistics, 1900-1913<br> <br> Small debt statistics from county courts, 1847-1913 and 1938<br>There are four tables in this part of the <i>Great Britain Historical Database</i>, providing a comprehensive account of changing administrative units in England and Wales over the period from 1888 to 1973:<br> <br> <i>Lgd</i> holds all the local government districts (county boroughs, London boroughs, municipal boroughs, rural districts and urban districts) in the GIS and acts as a gazetteer between the GIS and the <i>Great Britain Historical Database</i>.<br> <br> <i>Main_ch</i> holds the total information about each change, e.g. date, total population, total area, type of change, etc (This table is currently unavailable).<br> <br> <i>Sub_area</i> holds details of all the sub areas (ideally civil parishes) affected by the changes (This table is currently unavailable).<br> <br> <i>Lgd_to_cha</i> acts as a lookup table between <i>lgd</i> and <i>main_ch</i> (This table is currently unavailable).<br> <br> Please note: this study does not include information on named individuals and would therefore not be useful for personal family history research.<br> <br> <br

GIS of the Ancient Parishes of England and Wales, 1500-1850

Main Topics:In the middle of 2001 Roger Kain and Richard Oliver, from the University of Exeter, published a substantial work entitled Historic Parishes of England and Wales: Electronic Map - Gazetteer- Metadata. This was the final product of a project aimed at locating and mapping the boundaries of parish and sub-parish units of the mid-nineteenth century. The authors published the results in a series of electronic maps supplied on CD-ROM. Each one of these 115 maps contain a scanned 1”:1 mile OS New Popular Series map, overlain by the boundaries. A reference number can be found in each of the polygons that can then be used to look up information about that parish in gazetteer in an accompanying book. A major limitation of this work is that although the boundaries are in digital form, they are divided into 115 tiles, none of which have any spatial co-ordinate information inherent in them. This means that although the maps are invaluable as a reference tool, they can not be used together within a GIS to select, analyse and present historic information. We have therefore created a single digital map of the boundaries to provide a single, continuous coverage of polygons, each of which contain the information provided by Kain and Oliver in their accompanying book. This information includes the parish name, Ancient County, and a reference number that coincides with entries for that parish in the 1851 census report. It is recommended that users also order disc 1 of study 4348; Historic Parishes of England and Wales : an Electronic Map of Boundaries before 1850 with a Gazetteer and Metadata Please note: this study does not include information on named individuals and would therefore not be useful for personal family history research. <br