Microporous polysaccharide hemosphere absorbable hemostat use in cardiothoracic surgical procedures

BACKGROUND: Topical hemostatic agents are used to reduce bleeding and transfusion need during cardiothoracic surgery. We report our experience with Arista® AH Absorbable Hemostatic Particles (Arista® AH), a novel plant-based microporous polysaccharide hemostatic powder. METHODS: Data were retrospectively collected for patients (n = 240) that received cardiothoracic surgery at our institution from January 2009 to January 2013 with (n = 103) or without (n = 137) the use of Arista® AH. Endpoints included protamine to skin closure time (hemostasis time), cardiopulmonary bypass time, quantity of Arista® AH applied, intraoperative blood product usage, intraoperative blood loss, chest tube output 48 hours postoperatively, blood products required 48 hours postoperatively, length of stay in the intensive care unit, 30-day morbidity, and 30-day mortality. RESULTS: 240 patients (176 M: 64 F) underwent 240 cardiothoracic procedures including heart transplantation (n = 53), cardiac assist devices (n = 113), coronary artery bypass grafts (n = 20), valve procedures (n = 19), lung transplantation (n = 17), aortic dissection (n = 8), and other (n = 10). Application of Arista® AH led to significant reduction in hemostasis time versus the untreated control group (Arista® AH: 93.4 ± 41 min. vs. Control: 107.6 ± 56 min., p = 0.02). Postoperative chest tube output in the first 48 hours was also significantly reduced (Arista® AH: 1594 ± 949 mL vs. Control: 2112 ± 1437 mL, p < 0.001), as well as transfusion of packed red blood cells (Arista® AH: 2.4 ± 2.5 units vs. Control: 4.0 ± 5.1 units, p < 0.001). There was no significant difference in 30-day mortality or postoperative complications. CONCLUSION: Use of Arista® AH in complex cardiothoracic surgery resulted in a significant reduction in hemostasis time, postoperative chest tube output, and need for postoperative blood transfusion

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Recurrent Device Thrombi During Mechanical Circulatory Support With an Axial-flow Pump Is a Treatable Condition and Does Not Preclude Successful Long-term Support

The formation of pump thrombus after implantation of axial-flow ventricular assist devices has been described previously. We report a case of recurrent pump thrombus formation in a 63-year-old man who was bridged to heart transplantation with a MicroMed DeBakey ventricular assist device. He was treated with a low, dose-adjusted thrombolytic treatment protocol, and was subsequently successfully bridged to transplantation. Transient pump thrombus formation does not preclude safe long-term support with an axial-flow pump when diagnosed and treated appropriately

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study (Intensive Care Medicine, (2021), 47, 2, (160-169), 10.1007/s00134-020-06234-9)

1832The original version of this article unfortunately contained a mistake. The members of the ESICM Trials Group Collaborators were not shown in the article but only in the ESM. The full list of collaborators is shown below. The original article has been corrected.openopenLabeau S.O.; Afonso E.; Benbenishty J.; Blackwood B.; Boulanger C.; Brett S.J.; Calvino-Gunther S.; Chaboyer W.; Coyer F.; Deschepper M.; Francois G.; Honore P.M.; Jankovic R.; Khanna A.K.; Llaurado-Serra M.; Lin F.; Rose L.; Rubulotta F.; Saager L.; Williams G.; Blot S.I.; Muzha D.; Ribas A.M.; Lipovesty F.; Loudet C.; Eller P.; Mostafa N.; Honore P.M.; Telleria V.M.; Smajic J.; Nogueira P.C.; Nafees K.M.K.; Hentchoya R.; Soledad J.; Cardenas Y.; Reyes A.G.; Sustic A.; Mpouzika M.; Vymazal T.; Jensen H.I.; Aguirre-Bermeo H.; Maddison L.; Valta M.; Bloos F.; Adipa F.E.; Koulouras V.; Enamorado J.; Agoston Z.; Birgisdottir H.; Gupta A.; Gurjar M.; Kilapong B.; Hashemian S.M.; Martin-Loeches I.; Cortegiani A.; Fletcher K.; Hayashi Y.; Waweru-Siika W.; Abidi K.; Lee S.-M.; Hadri B.; Dolgusevs M.; Abillama F.F.; Jovaisa T.; Thix C.; Elhadi M.; Nor B.M.; Ratnam S.; Mazlan M.Z.; Maiyalagan S.; Sanchez-Hurtado L.; Belii A.; Naranpurev M.; Gautam P.; De lange D.; Parke R.; Ilesanmi R.E.; Shosholcheva M.; Petosic A.; Lind R.; Ffarcsi M.H.; Bogarin J.; Hernandez A.M.; Mikaszewska-Sokolewicz M.; Sousa B.; Tomescu D.; Sandesc D.; Twagirumugabe T.; Gusarov V.; Ebaid M.; Slobodianiuk G.; Martonova A.; Knafelj R.; Mer M.; Maseda E.; Panka B.; Schefold J.C.; Joelsson-Alm E.; Trongtrakul K.; Merritt-Charles L.; Besbes L.O.; Dikmen Y.; Zgrzheblovska L.; Fielding M.; von der Osten I.; Muzha D.; Greca A.; Cani A.; Xhindi N.; Hyska G.; Ribas A.M.; Pinto S.; Alves P.; Esposito R.; Valgolio E.; Minope J.T.S.; Abdala A.; Ayala M.; Bravo S.; Bantar A.; Delgado P.; Badariotti G.; Lipovestky F.; Diaz A.; Saul P.; Setten M.; Aucapina A.; Acosta Y.; Gonzalez V.; Camputaro L.; Baccaro F.; Villa R.; Diaz A.; Mastantuono M.; Dean E.; Rostello O.F.; Brizuela P.; Bartoli J.R.; Guereschi M.; Quiroga C.; Putruele S.; Villegas P.; Curilen V.; Fernandez R.; Nocheretti M.G.; Escalante R.G.; Loudet C.I.; Fernandez S.; Gonzalez A.L.; Alvarez G.A.; Iglesias F.; Chaparro S.; Zakalik G.; Pagella G.; Baini M.; Campos P.A.; Sabbag I.; Schmukler A.; Fonseca I.P.; Alvarez G.M.; Ramirez M.; Tapia F.; Bascary C.A.; del Valle Gimenez G.; Bertoletti F.P.; Milioto E.; Bonsignore P.J.M.; Fernandez M.A.; Smith J.; Chimunda T.; Thompson L.; Maguire T.; Watts S.; Mitchell M.; Powell M.; Lye I.; Parsons L.; Baker N.; Reynolds C.; Thompson A.; Masters K.; Sosnowski K.; Morrison L.; Leslie G.D.; Lakshmanan R.; Tabah A.; Brown W.; McDowell-Skaines S.; McLucas A.; Smith C.; Tallot M.; Jones S.; Barakat-Johnson M.; Leong T.; Butcher R.; Martin K.; Douschan P.; von Lewinski D.; Eller P.; Schmutz R.; Kolussi U.; Salman F.; Ateya Z.; Mostafa N.; De Decker K.; Van Regenmortel N.; Jans A.; Wijnands P.; Coremans S.; De Bels D.; Depuydt T.; Paillet C.; Jacquet L.-M.; Swinnen W.; Hannes F.; Mergeay M.; Van de Velde S.; Allaert S.; Hoste P.; Borin C.; Balon S.; Fraipont V.; Biston P.; De Schryver N.; Dugernier T.; Van Cotthem I.; Telleria V.M.; Smajic J.; de Almeida A.O.; Jorge S.A.; Becker D.; Schmidt R.C.; Oliveira E.; Ramalho A.; Mazocoli E.; Fioretti A.; Barros E.; Serpa L.; Bianchini S.; Campanili T.; Pantaleao T.; Garcia P.C.; Ronchini A.L.V.; Santos R.; Nafees K.M.K.; Manap N.B.A.; Hentchoya R.; Bagshaw S.; Carney D.; Bagshaw S.; Davidow J.; Bagshaw S.; Rokosh E.; Bagshaw S.; Laizner A.M.; Smith S.; McQuirter M.; Kampayana B.S.; Favre R.; Sills M.; Laizner A.M.; Dallaire J.; Laizner A.M.; Becker C.; Microys S.; Bowes B.; Lajeunesse J.; Ghosh R.; Baptiste-Savoie J.; Raizman R.; Bagshaw S.; Suen G.; Taghavi N.; Smith O.; Fielding C.; Canales J.; Molina P.; Chaparro J.; Sepulveda M.I.; Zamorano M.J.F.; Rocha P.; Villanueva X.; Araya P.; Dayan M.; Avalos F.; Li X.; Liu Y.; Li X.; Chen X.; Jiang Z.; Yang J.; Chen J.; Yang L.; Wang K.; Gao J.; Fang X.; Zhao R.; Xia X.; Liu H.; Li J.; Wang H.; Meng G.; Di Y.; Wang D.; Zhao R.H.; Hu L.P.; Fang X.; Peipei X.; Jiao Q.F.; Wang H.Y.; Xia C.J.; Liu Y.; Ye M.; Wan Y.; Wang W.; Ding Y.; Ren A.; Gao Y.; Li Q.; Du G.; Yang J.; Shen Y.; Ding Y.; Li N.; Yuan C.; Li J.; Tan L.; Lin Q.; Guo H.; Yan H.; Xu X.; Zhang W.; Liang J.; Zhang L.; Tian E.; Zhao Q.; InSu L.; Dong J.; Gu Y.; Liu Y.; Zhao L.; Wang W.; Qiao H.; Tuo L.; Lv M.; Zhu J.Y.; Zhu J.F.; Wei Y.; Liu M.; He Y.; Cheng J.; Liu J.; Jia N.; Wei D.; Li Q.; Wu X.; Duan H.; Lin D.; Liang Q.; Luo X.; Xiong Y.; Huang R.F.; Fu J.; Zan T.; Ye M.; Shi Z.; Long Y.; Lei Y.; Liu X.; Yumei C.; Wang L.L.; Zhang Y.; Xu Y.; Cheng; Zhijuan W.; Sun C.; Song J.H.; Wang Y.; Liu X.M.; Liu Y.; Yuan Y.; Huang Q.; Yang F.; Wu Y.; Luo X.; Bai X.; Zheng H.; Song M.; Sun Y.; Li Z.S.; Luo F.; Liu M.; Li L.C.; Li X.; Zhang G.; Xiao L.; Yu T.; Gao G.; Wei W.; Wang F.; Han T.; Li T.; Zeng Q.; Zeng J.M.; Long Y.; Pan F.; Wang J.; He G.; Chen H.; Zhang F.; Chao Y.; Chunhua G.; Yao X.; Bai D.; Liu L.; Xu X.; Wang Y.; Liang X.; Zhang N.; Li X.; Zhang A.; Chen X.; Hu X.C.; Zhang H.; Wang R.X.; Tak P.S.; Ho S.W.; Jiang Q.X.; Ding X.; Hong L.; Miao L.; Feng Z.; Huang L.P.; Wu J.; Wang Y.; Guo J.; Zhang B.; Ma C.; Han Y.; Liu C.; Ding M.; Luan L.; Zheng J.; Lv S.; Jiang S.; Cao W.; Xue X.; Li J.; Liu G.; Wang J.; Wei X.; Zhang W.; Jiang Y.; Yao Z.; Gao L.; Li J.; Zhao W.; Jiang M.; Hao J.; Zhang J.; Song C.; Chen F.; Wang S.; Hu L.; Cao D.; Liu Y.; Wan J.; Wang X.; Shao H.; Zhang Z.; Cui X.; Liu J.; Zhao L.; Li X.; Fan L.; Zhang L.; Yu M.; Li B.; Li C.; Liu L.; Liu X.L.; Chen W.; Li Y.; Zhigang Z.; Yuchen W.; Mu C.; Zhu G.; Yang F.; Bo Q.; Li L.; Chen M.; Jiang J.H.; Yin H.; Pang X.; Gong Y.Y.; Yang S.; Yan X.; Zheng X.; Lei D.H.; Lei L.; Guo Y.; Liu L.; Yu J.; Sun W.; Bi A.P.; Li W.; Wu Y.; Li J.; Ni D.; Li X.; Liu Y.; Wu Z.; Song B.; Chen J.; Fei Q.; Xiaoyan Y.; Ran Q.; Xixi L.; Jiao X.; Ji H.; Zhiping S.; Hong M.; Jianhong M.; Hao Y.; Yin L.; Wang Y.; Hui C.; Ju W.; Xia X.; Huo Y.; Wang Y.; Chen L.; Yan Y.; Zhao Q.; Chen H.; Bao G.; Cao Y.; Hong L.; Zhang H.; Zhang Y.; Xu L.; Guixiang J.; Li Y.; Zhao H.M.; Huang X.; Dai Z.; Jian Y.; Zhang H.; Tian Z.; Cao Z.Q.; Li M.; Liu Y.; Ouyang F.; Ma F.; Jin W.; Ge L.; Wu S.F.; Li J.; Yuan W.; Chen T.; Shi G.; Chen Z.; Liu K.; Lin X.; Yuemen L.; Lijuan S.; Tian X.F.; Wang S.; Feng Z.X.; Liu X.Z.; Dong Y.; Zhang J.; Bocui N.; Jiang Z.X.; Yang J.; Wang G.X.; Zhao Y.; Wu X.; Yang Q.; Hu R.L.; Li X.Q.; Yu Z.J.; Yao Y.; Deng X.; Xiao Y.; Xie Y.; Yang Y.; Yang H.; Zhou Y.; Li Z.; Xiao M.; Yang Y.X.; Tian Y.; Gama L.M.S.; Hernandez J.S.; Cardenas Y.; Caicedo N.; Marin J.; Ochoa M.-E.; Gomez M.; Rojas-Suarez J.; Gonzalez J.; Reyes A.J.G.; Chapeta E.; Orozco E.; Filipovic-Grcic I.; Vukovic A.; Pecenkovic S.; Suput A.; Sustic A.; Zivanovic-Posilovic G.; Bozena A.; Udiljak N.; Milic M.; Radivojevic R.C.; Mihaljevic S.; Matas M.; Tonkovic D.; Culjak H.; Herceg I.; Pavlisa G.; Dobric M.; Beker T.; Adam V.N.; Goranovic T.; Markoulias C.; Mathaios M.; Mylordou M.; Achilleos E.; Kleanthous P.; Kotanidi V.; Foka M.; Charalabous I.; Alexandrou A.; Georgiou M.; Patsalos A.; Zepoy S.; Constantinou C.; Piza P.; Vymazal T.; Wiborg E.; Bruhn L.; Kaasby K.; Pedersen K.R.; Mikkelsen S.; Collet M.; Langvad A.; Andresen H.; Fischer S.; Kjaergard I.E.; Jepsen B.; Husted B.; Bestle M.; Kodal A.M.; Hansen T.C.B.; Pedersen A.S.B.; Thomsen T.D.; Hoegenhaven A.; From M.; Frandsen T.M.; Henning G.; Hansen A.; Jensen H.I.; Bliksted I.A.; Tamayo L.M.; Mogrovejo P.; Aguirre-Bermeo H.; Palaez C.; Tutillo D.R.M.; Hurtado C.V.; Garcia M.F.; Alvarez D.; Guerrero F.; Vasquez A.; Kutimets M.; Tamme K.; Maddison L.; Anvelt E.; Dlamini-Sserumaga L.; Lofqvist C.; Lusenius V.; Kauppi O.; Sakki J.-K.; Tervo-Heikkinen T.; Kesti U.; Merilainen M.; Karjula E.; Peltomaa M.; Palmu A.; Ahtiala M.; Valta M.A.; Mentec H.; Plantefeve G.; Besch G.; Pili-Floury S.; Ledochowski S.; Deserts M.D.; Giacardi C.; Daubin C.; Massard A.; Le Guen Y.; Blanc A.; Mandaroux S.; Gunther S.C.; Avogadro P.; Radavidson A.; Turc J.; Jochmans S.; Quintard H.; Boyer L.; Bruel C.; Philippart F.; Montravers P.; Atchade E.; Flessel N.; Chinardet B.; Soulisse L.; Pillard C.; Ngo D.; Bongiorno B.; Heitzler N.; Souppart V.; Gautheret N.; Timsit J.-F.; Essardy F.; Fartoukh M.; Mehay D.; Etourneau F.; Farkas J.-C.; Beuret P.; Preda G.; De Montmollin E.; Castelain V.; Jaschinski U.; Rothenfusser M.; Kindgen-Milles D.; Dimski T.; Fiedler C.; Heinicke T.; Meybohm P.; Schulze T.; Bota M.; Pelz S.; Odenthal T.; Christ M.; Bloos F.; Bosl K.; Chovas A.; Stehr S.; Simon P.; Grotheer S.; Schuppel S.; Schaller S.; Albrecht L.; Stubner A.; Graeser S.; Kolbe N.; Lausch M.; Diers A.; Guenther U.; Riessen R.; Roller M.; Osei I.P.; Kusi-Appiah A.-C.; Yakubu Y.H.; Guadi-Gosh B.; Dragoumanis C.; Christofis C.; Kazakos N.; Bastani S.; Martinos C.; Bekos V.; Papanikolaou M.; Papavasilopoulou T.; Efthymiou A.; Chantziara V.; Kyriakoudi A.; Kakaras N.; Diakaki C.; Flevari A.; Nikolaou C.; Katerina K.; Avramopoulou L.; Tsikritsaki K.; Gkiokas G.; Pantiora E.; Katsenos C.; Patsiou E.-C.; Alexandropoulou P.; Koutsodimitropoulos I.; Farmakis E.; Nestora K.; Chatzis M.; Kondili E.; Soundoulounaki S.; Mousafiri O.; Lepida D.; Liarmakopoulou A.; Koulouras V.; Papathanakos G.; Oikonomou M.; Ioannides P.; Papadopoulos D.; Staikos I.; Stafylaraki M.; Raitsiou B.; Mandis K.; Ravani I.; Kourelea S.; Efthimiou A.; Thoma G.; Bakas A.; Psarulis K.; Anisoglou S.; Papageorgiou E.; Michailidou E.; Tholioti T.; Lavrentieva A.; Sourla E.; Spyropoulou A.; Pantelas N.; Stalika K.M.M.; Georgakas I.; Karathanou A.; Tsikriki S.; Dimoula A.; Kanakaki S.; Vakalos A.; Pagioulas K.; Enamorado J.E.; Nardai G.; Hawchar F.; Blondal A.; Rygvadottir B.; Jonasdottir R.J.; Birgisdottir H.; Shah B.; Kaushik S.; Tripathy S.; Singh M.; Agarwal S.; Gupta M.; Ahmad M.; Mangal K.; Bhargava V.; Kushare V.; Jha S.; Bhakhtiani L.; Gupta A.; Kamal M.; Gurjar M.; Baronia A.; Kilapong B.; Susanti A.; Lestari M.I.; Zulkifli Z.; Baskoro W.; Zand F.; Zarei F.; Mahmoodpoor A.; Heidari F.; Jafaraghaee F.; O'Shea A.; O'Shea F.; O'Donnell C.; Craig G.; Fitzpatrick G.; Dunne L.; Hastings J.; Marsh B.; Cody C.; Campbell E.; Doyle D.; Pacturanan M.; Sheehan C.; Carey A.; Carter C.; Mulvey R.; Finn D.O.C.R.; Motherway C.; Walsh A.; Kehoe J.; Delossantos S.; Lalor J.; O'Nuallain S.; Behan H.; McPherson S.; Corcoran A.; Gordon P.; Rooney G.; Levy D.; Azencot M.; Gurevich V.; Lavy A.; Bendelari V.; Marconi R.; Barone A.; Gatti C.; Giampaoletti A.; Borgognoni C.; Ghioldi D.M.; Raimondo A.; Castiglione G.; Bruno A.V.; Rubulotta G.; Mo A.; Corso A.; Girianni S.; Bruni A.; Garofalo E.; Maggiore S.M.; Di Risio A.; Calamai I.; Spina R.; Spadaro S.; Volta C.A.; Cotoia A.; Mirabella L.; Maulicino L.; Abregal G.; Donvito M.; D'Ambrosio P.; Binda F.; Adamina I.; Galazzi A.; Negro A.; Vaschetto R.; Capuzzi F.; Boschetto M.; Stivanello L.; Bonaccorso L.; Megna C.; Cortegiani A.; Iozzo P.; Rizzo A.; Scire G.; Taibi M.R.; Tranello F.P.; Manzo A.; Traina L.; Pastore B.; Quaini A.; Giusti G.D.; Montaldi G.; Piergentili F.; Mancini F.; Casaioli S.; Uccelli F.; Guarracino F.; Onelli A.; Di Gravio V.; Cossu M.; Matrona O.; Rocco M.; Alampi D.; Dellafiore F.; Ranalli F.; Bossolasco M.; Brizio E.; Migliorino P.; Cortellazi P.; Rosati M.; D'Ambrosio F.; Quagliotto C.; Roman-Pognuz E.; Peratoner A.; De Rosa S.; Martin M.A.; De Sanctis F.; Ciorba P.; Fletcher K.; Toppin P.; Harding-Goldson H.; Taito S.; Shime N.; Yamamoto R.; Kanda F.; Hirao A.; Egi M.; Noguchi A.; Hashimoto S.; Aya U.; Sakuramoto H.; Ohuchi A.; Kataoka J.; Maruyama K.; Nakayama I.; Nishime Y.; Fujimoto K.; Takahashi K.; Tsujimoto M.; Shimizu M.; Waweru-Siika W.; Tole E.; Correia M.C.; Kim J.H.; Park S.; Kim K.C.; Baek J.; Bae J.-M.; Park S.Y.; Park T.S.; Lee H.B.; Park S.Y.; Park J.; Yeon-Joo L.; Young-Jae C.; Lee S.-M.; Jeon K.; Kim S.C.; Lee J.; Chee H.K.; Huh J.W.; Sim Y.S.; Kim J.; Chang Y.; Ahn J.-J.; Kang B.J.; Lee W.-Y.; Lee S.J.; Hadri B.; Baftiu N.; Krastins I.; Dolgusevs M.; Abillama F.F.; Stiban S.; Feghaly M.E.; Gharios E.; Merheb M.; Benlamin M.; Khaled A.; Belkhair W.A.; Tabib M.; Ashour F.; Elhadi A.; Tababa O.W.E.; Khaled T.; Alkhumsi S.I.R.; Alshrif A.I.; Aboufray A.A.; Alabuzidi A.; Triki A.R.; Elgammudi M.; Zahra H.B.; Soula E.; Al-Alawi M.M.S.; Ahmed H.; Ghula M.A.A.; Vosylius S.; Mouton L.; Rastegar T.; Sertznig C.; Martin G.; Thix C.; Theisen C.; Ferretti C.; Gils F.; Gallion M.; Zainudin A.; Bahrin L.K.K.; Deva S.R.; Rahim A.H.A.; Wahab S.; Mazlan M.Z.; Hassan W.N.W.; Ismail W.N.W.; Ali M.N.; Khoo T.M.; Samat N.M.; Tong J.M.G.; Adib N.A.N.; Nor M.B.M.; Ratnam S.; Ismail N.; Ratnam S.; Sulaiman S.R.; Foong K.W.; Alias A.; Hua N.P.; Maiyalagan S.; Maiyalagan S.; Zermeno J.M.; Blanco D.; Duran K.; Nava C.L.L.; Nandyelly S.J.R.; Sanchez-Hurtado L.A.; Tejeda-Huezo B.; Del Moral Armengol M.; Nava L.P.A.; Herrera J.G.; de Anda G.F.V.; Gallegos-Perez H.; Hernandez-Sanchez N.; Hernandez-Ponce L.; Gorordo-Delsol L.; Hernandez-Romero M.; Gomez S.; Molinar F.; Namendys-Silva S.A.; Romero-Gonzalez J.P.; Gonzalez D.; Landaverde A.; Sosa M.A.; Navarro B.; de Molina Serrano J.I.R.; Iburrigarro S.R.; Ibarra A.; Aguirre J.; Martinez-Gonzalez M.; Padilla N.R.C.; Pineda A.A.V.; Villafuerte M.V.E.; Herrera M.O.G.; Belii A.; Naranpurev M.; Baasanjav B.; Hachimi A.; Elkhayari M.; Abidi K.; Dendane T.; Subedi N.B.; Pathak S.D.; Gautam P.; Manandhar M.; Van Gulik L.; Van Den Brink M.; Van Vliet P.; Gerretsen B.; Van Den Berg L.; De Haan M.; Tuinstra B.; Kuijpers P.; Reijntjens J.; Vermeijden J.W.; Rinket M.; Vanroest M.; Reidinga A.; Loef B.; Dieperink W.; Onrust M.; Dormans T.; Bormans L.; Koopmans M.; Gerritsen R.T.; Van Den Elst A.; Evers M.; Oiting O.; Wilting R.; Ramaker B.; van der Kuil M.; Fijen J.-W.; Haas L.; De Lange D.; Haringman J.; Newby L.; Parke R.; Gilder E.; Hacking D.; Dagooc R.; Song R.; Waibel H.; Dawn F.; Rapley J.; Chadwick L.; Chapman C.; Crone P.; Albrett J.; Marko P.; Goodson J.; Browne T.; Whitticase R.; Davidson C.; Judd H.; Owens D.; Onyeka T.; Ugwu I.; Ilesanmi R.; Adejumo P.O.; Owojuyigbe A.; Adenekan A.; Uba S.; Chime C.; Jibrin D.; Sankey B.J.; Adekola O.; Olanipekun S.; Olanipekun S.; Adekola O.; Shosolcheva M.; Gievski V.; Kartalov A.; Naumovski F.; Kuzmanovska B.; Trposak A.; Bogoevska-Miteva Z.; Rosalia R.; Olsen B.F.; Sjobo B.; Jensen K.D.; Sykehus D.; Johansen B.F.; Straede E.; Johansen E.; Finnstrom I.J.; Toellefsen A.; Ostenjo H.; Bjorgen H.; Bratsberg B.; Kristoffersen E.; Skorstad E.M.; Hansen S.; Vullum S.; Lunde G.A.; Arntsen W.; Lund M.; Akselsen G.R.; Monstad K.R.; Stenset A.; Haugom H.; Monsen B.; Hogvall L.; Trudvang S.; Galaaen B.; Malmin S.K.; Andersen M.H.; Hargott R.F.; Andersen Y.; Steffenak E.; Nyhus M.; Meland B.; Hashmi M.; Rivas N.; Maidana E.; de Jesus Ortiz A.; Cabral D.M.B.; Simi M.; Aponte C.; Rivas J.C.; Gill S.; Garcia A.; Alvarenga G.; Cespedes L.; Perez H.; Moreira M.L.; Canete F.; Gonzalez R.; Monges N.; Garcia A.; Coman M.; Pederzani M.; Franco N.; Aganon F.; Martinez R.; Noblezada-Uy D.; Ellazar C.G.; Cerezo F.D.; Hernandez A.M.; Palo J.E.; Aperocho C.A.J.; Isanan M.; Tubacka M.; Jasiewicz P.; Czuczwar M.; Borys M.; Gutysz-Wojnicka A.; Glinka L.; Gawda R.; Mikaszewska-Sokolewicz M.; Bilawicz J.; Cabrita P.; Vieira J.; Figueiredo M.F.; Pinheiro C.M.; Antunes N.; Pedro L.; Ferreira F.; Parente I.; Varela M.; Fernandes F.; Martins C.; Viveiros A.; Cavaco R.; Rita C.S.; Dias S.; Feranandes A.M.; Silva P.; Nunes C.; Cabral J.; Sousa B.; Pires F.; Ferreira H.; Santos J.; Pinto V.M.V.; Bispo B.M.; Ferreira A.; Molinos E.; Lafuente E.; Gregorio R.; Costa H.; Lima A.; Ferreira S.; Seromenho V.; Luis E.; Valerio I.; Cesar H.; Tavares A.; Alsheikhly A.S.; Mahmood S.; Guran C.T.; Moise A.; Filipescu D.C.; Luchian M.; Tomescu D.; Popescu M.; Scutariu M.A.; Petrisor C.; Hagau N.; Grigoras I.; Patrichi T.; Gusarev V.; Pivkina A.; Kulakov V.; Ignatenko O.; Kovaleva J.; Zhivotneva T.; Zhedaeva M.; Matiushkov N.; Ershova O.; Egorova N.; Khoronenko V.; Baskakov D.; Sergeev D.; Piradov M.; Grishina L.; Magomedov M.; Zuev E.; Gorokhovatsky U.; Leonova A.; Fadeeva L.; Belskiy V.; Galishevskiy D.; Zubareva N.; Tribulev M.; Zueva O.; Kiselev A.; Kamenshchikov N.; Tokareva E.; Petrushin M.; Starchenko I.; Twagirumugabe T.; Nshimyumuremyi I.; Muhizi J.; Buregeya E.; Nzarora J.; Assiri A.; Ebaid M.S.; Almekhlafi G.; Mandourah Y.; Velickovic J.; Velickovic D.; Jovanovic B.; Hadzibegovic A.; Stefanovic B.; Misic V.; Bumbasirevic V.; Rajkovic M.; Stojanovic M.; Gavrilovic S.; Stanojevic M.; Martonova A.; Yaghi A.; Turcan A.; Firment P.; Slobodianiuk G.; Rabarova D.; Lancaricova D.; Vlaovic J.; Groznik M.; Lukic M.; Perme J.; Sostaric M.; Umek N.; Mirkovic T.; Dolenc S.; Knafelj R.; Fister M.; Zorko N.; Markota A.; Yeni N.P.; Jali P.; Schmollgruber S.; Syed M.R.; Parag N.; Wise R.; Galiana M.; Navarro J.A.; De Pablo A.M.; Albert P.; Martinez P.; Mendiara Y.; Garcia B.; Llinas A.A.; Riveiro M.; Gallart E.; Riera A.; Sanz M.; Salo S.; Lajara M.A.G.; Nieto M.V.; Garcia R.; Pena J.M.G.; Gorgolas M.C.; Isasi M.A.; Sierra R.; Gordo F.; Conejo I.; Salva-Costa V.; Garzon-Tovar C.; Lospitao S.; Gonzalez R.; Gutierrez P.; Girona M.; Adamuz J.; Olivares P.G.; de Ceballos J.P.G.; Tirado C.; De Wit I.; Polo A.B.C.; del Mar Diaz Salcedo M.; Ripolles-Melchor J.; Martinez-Hurtado E.; Alvarez J.D.; Arcas M.L.B.; Gonzalez J.I.T.; de la Ventana A.B.S.; Calleja P.L.-A.; Alvarez R.G.; Zamora P.S.; Guerrero A.O.; Cosano R.; Perez-Vacas J.; Campos-Perez M.; Barreiro E.M.; Sanchez L.C.; Diaz M.G.; Jimenez R.; Del Rio Cabajo L.; Muriel D.S.; Alonso H.F.; Fernandez A.W.; Pinan I.S.; Albaiceta G.M.; Fernandez M.C.I.; Abos F.J.S.; Monedero P.; Chueca R.M.; Aguirre L.G.; Manosa S.C.; Luque C.P.; Calpe N.; Losilla M.R.; Fores M.T.; Farre O.; Fernandez O.; del Rosario Villar Redondo M.; Arteta Arteta D.S.; Sanchez M.A.H.; Espinosa C.P.; Reyes L.M.; Domenech L.C.; Guillen C.V.; Alvarez J.T.; del Cotillo M.; Barrueco-Francioni J.E.; Conde B.B.; Blanco M.P.S.; Blasco M.L.; Clement A.I.; Hurtado C.; Sanz L.C.; Perez-Torres D.; Prol-Silva E.; Pereira J.; Gonzalez I.A.; Cano A.E.; Nunez C.R.; Fernadez I.L.; Fernandez A.A.M.; Del Bosque Diez R.; Hilario B.; Zalba-Etayo B.; Pascual-Bielsa A.; Panka B.; Banwarie P.; Nahar D.; van Axel A.; Boedjawan N.N.; Jansson E.B.; Malvemyr A.-S.; Johansson L.; Sandberg U.; Tingsvik C.; Mattsson G.; Lof G.; Spangfors M.; Ringdal M.; Geijer S.; Orvelius L.; Hylen M.; Lagerhall C.; Joelsson-Alm E.; Akerman E.; Hellkvist V.H.; Mickelsson U.; Akerman E.; Wahlbom E.; Larsson I.-M.; Wallin E.; Boroli F.; Ory S.; Jong M.L.; Dullenkopf A.; Lang M.; Fleury Y.; Maus M.; Ben-Hamouda N.; Fishman A.; Hsu M.Y.; Chang S.C.; Trongtratul K.; Sawawiboon C.; Morakul S.; Khwannimit B.; Merritt-Charles L.; Singh K.; Ventour D.; Figaro-Barclay D.; Sankar-Maharaj S.; Mebazaa M.S.; Kamoun S.; Elatrous S.; Besbes L.; Abroug F.; Naija W.; Elhechmi Y.Z.; Sellami W.; Hajjej Z.; Merhabene T.; Talik I.; Kuscu O.O.; Dilek O.; Zerman A.; Dal H.C.; Turan S.; Aydemir S.; Yilmaz H.; Calili D.K.; Izdes S.; Cengiz M.; Gumus A.; Tasdemir B.; Kagnici A.; Ay M.; Ay S.A.; Caliskan G.; Akbas T.; Balbay A.O.; Efe S.; Inal V.; Elay G.; Karabacak P.; Ozserezli B.; Senturk E.; Demirkiran O.; Bozbay S.; Dikmen Y.; Erdogan E.; Akker M.; Peker N.; Ozgultekin A.; Serin S.O.; Turan C.; Karaoren G.; Goksu S.; Karakurt S.; Arikan H.; Gul F.; Cinel I.; Kara I.; Undar H.N.; Bayraktar Y.S.; Celik J.B.; Tokur M.E.; Aydin D.T.; Yildiz I.; Ozcan B.; Erdivanli B.; Erdivanli B.; Ozcan B.; Eroglu A.; Akdag D.; Unlu N.; Fielding M.; Dungca A.; Ali A.; Thankamma B.; Reyes P.E.; John S.; Rajendran A.; Ahmad F.K.E.; Smiley K.A.; Hojden S.; Miller M.T.; Das Sasidharan Nair V.; Antonio M.G.S.; Qawasmeh K.A.; Shawish S.A.; Twiggs H.; Rosado I.; Babych V.; Morren F.; Young C.; Vaughan-Jones N.; Harris S.; Burns K.; Georgiev C.; Shayamano R.; Kerslake I.; Creber P.; Vochin A.; O'Brien C.; Caddell P.; Hagan S.; Hughes M.; Torlinski T.; Sherwin J.; Kannan S.; Markham A.; Lebon R.; Cupitt J.; Cranshaw J.; White N.; Marriott V.; Milner W.; Groba C.B.; Azoia J.; Polgarova P.; George S.; Kapoor R.; Lynch C.; Fox N.; Cranmer K.; Fox N.; Llewellym T.; Matthews K.; Maltby L.; Ibao J.; Boulton K.; Jarman R.; Baxter K.; Raj A.S.; Moghal A.; White J.; Barrowcliffe S.; Pulletz M.; Ganeshalingam V.; Baruah R.; Baker H.; Woods J.; Ei P.P.; Ogbeide V.; Hayden P.; Matthews K.; Hughes J.; Balasubramanian M.; Salberg A.; Saha R.; Holmquist D.; Young C.; Derbyshire C.; Smith N.; Stones E.; Ademokun J.; Popescu M.; Legorburo M.S.; North S.; Brett C.; Jaundoo H.; Craig J.; Whiteley S.; Howcroft C.; Wilby L.; Delve P.; Shaw D.; Williams K.; Welters I.D.; McMullen J.; Brett S.; Flores L.; Trueman-Dawkins T.; Templeton M.; Adams J.; Smith C.; Prowle J.; Byers H.; McDonnell A.; Rose B.O.; Reece-Anthony R.; Mendes L.; Vizcaychipi M.; Bull R.; Lacaden G.; Santiago E.; Delgado C.C.; Farnell-Ward S.; Thorpe E.; Somerville J.; Williams A.; Cummings D.; Derrick H.; Brumwell S.; Randell C.; McCann N.; Aves E.; Berry G.; Szakmany T.; Gunter U.; Pulak P.; Sarkar N.; Wright K.; Gomes V.; Jones J.; Palfrey R.; Camsooksai J.; Lewis A.; Eneas A.; Tridente A.; Barr L.; Jovaisa T.; Thomas B.; Parkin E.; Horner D.; Frey C.; Bench S.; Baumber R.; Broadhurst P.; Jackson M.; Williams L.; Clark M.; Paddle J.; Bean S.; Buckley S.; Palfreeman C.; Liu S.; Allison N.; Attwood B.; Parsons P.; Houghton V.; Turner S.J.; Higgins D.; Bielskute E.; Horrigan N.; Jacob R.; Habgood K.; Zaki A.; Collins A.; Lord J.; Ramiro C.; Kubisz-Pudelko A.; Kotze M.; Williams H.; Iovenko I.; Tsarev A.; Zgrzheblovska L.; Briva A.; Mendez G.; Napolitano L.; Teig M.; Lee J.; Rodriguez G.E.; Ben-Jacob T.; Potestio C.; Eng T.; Mahanes D.; Khanna A.; Duggal A.;

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease