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

Westminster College Northern and Southern California alumni associations scrapbook

ScrapbooksThis collection consists of a single scrapbook. The materials record the activities of the Northern and Southern California alumni associations of Westminster College (Salt Lake City, Utah) from their creations in 1932 and 1935 respectively, until 1940.; This collection consists of a single scrapbook. The materials describe the activities of the Southern and Northern California alumni associations of Westminster College (Salt Lake City, Utah) from their creations in 1932 and 1935, respectively, until 1940.; Each section (Southern and Northern California) contains a typescript draft of a letter, with pencilled edits, from College President H.W. Reherd entitled "A suggested Constitution" in which he outlines creation and organizational points for the two alumni associations. The text begins with "The name of this organization shall be the Westminster College Alumni Association of No. Cal. (pencilled So.). Regarding membership, President Reherd suggests "former students, teachers and trustees of the Salt Lake Collegiate Institute, and of Westminster College shall be considered members of this Association." He goes on to proposed officers, methods of record-keeping, and concludes with his wishes for continued prosperity for the association.; The Southern California association materials are in the first section of the scrapbook. Following the "Constitution" letter is a history of the Association -- brief 1-paragraph descriptions (summary minutes) of nine meetings held between the winter of 1932 and March 15, 1940 in the case of the Southern California association. While the first three annual meetings were held in Winter, January, and April, the later ones were all held in March of each year. All meetings were held in Los Angeles and included a dinner. The location was either the New Rosslyn Hotel (1932-1935, 1938-1940) or the Mona Lisa Restaurant (1936-1937). The association is referred to as either the "Westminster College Alumni Association of Southern California" or as the "Southern California Alumni Association of Westminster College."; The Northern California Alumni Association's history (in the second section of the scrapbook) provides similar information on six annual meetings between March 12, 1935 and March 9, 1940. Four were held in March, the other two in February. Meetings included a dinner and took place in San Francisco at the William Taylor Hotel (1935), the Plaza Hotel (1936 and 1938), the Olympic Hotel (1937), the Victoria Hotel (1939). The last meeting documented by materials in the scrapbook took place at the Claremont Hotel in Berkeley, California (1940). This "Bay Area" association is referred to as either the "Westminster College Alumni Association of Northern California" or as the "Northern California Alumni Association of Westminster College."; Many of the accounts of the annual meeting include a list of attendees. All meetings were attended by President Reherd, often accompanied by his wife. Reherd even attended some following his 1939 resignation as president. The election of new alumni executive officers is also included for 1940. Most meetings consisted of members singing their favorite Westminster songs and reminiscing about their days at Westminster College (the earliest campus on 200 North and 200 East in Salt Lake City, life in the boys' dormitories, etc.). The current state of Westminster College events and organizations was also of interest, including the Women's Association activities and outstanding student work on campus. A personal memorandum by President Reherd describes the business and joviality of the ninth Southern California meeting. Overall, the scrapbook shows the growth of the organizations and the desire of alumni to remain connected with Westminster College.; The scrapbook is separated into two sections, the first half concerning the Westminster College Alumni Association of Southern California, and the second half concerning the Westminster College Alumni Association of Northern California. The materials in each section are in chronological order.; Biographical Note; Maintaining connections between Westminster College and its alumni and alumnae has been an important activity throughout the college's existence. The Alumni Relations Office maintains the Westminster Alumni webpage. The site links to information on alumni services, events (such as Reunion weekends), continuing education opportunities, the Alumni Board, Alumni House, news, publications, and contact information for the Alumni Office staff.; Scrapboo