dc.creator | Tallón Aguilar, Luis | es |
dc.creator | Toro López, María Dolores del | es |
dc.creator | Pareja Ciuró, Felipe | es |
dc.creator | Oliva Mompeán, Fernando | es |
dc.creator | Gómez Rosado, Juan Carlos | es |
dc.creator | Valdés Hernández, Javier | es |
dc.creator | Capitan-Morales, Luis-Cristobal | es |
dc.date.accessioned | 2023-09-22T10:21:09Z | |
dc.date.available | 2023-09-22T10:21:09Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Tallón Aguilar, L., Toro López, M.D.d., Pareja Ciuró, F., Oliva Mompeán, F., Gómez Rosado, J.C., Valdés Hernández, J. y Capitán Morales, .C. (2021). Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: An international cohort study. BMJ Open, 11 (11), 1-19. https://doi.org/10.1136/bmjopen-2021-050830. | |
dc.identifier.issn | 2044-6055 | es |
dc.identifier.uri | https://hdl.handle.net/11441/149109 | |
dc.description.abstract | Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.
Setting Prospective, international, multicentre, observational cohort study.
Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).
Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.
Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).
Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups. | es |
dc.description.sponsorship | European Society of Coloproctology | es |
dc.description.sponsorship | National Institute for Health Research (NIHR) Global Health Research Unit Grant (NIHR 16.136.79) | es |
dc.description.sponsorship | Association of Coloproctology of Great Britain and Ireland | es |
dc.description.sponsorship | Association of Upper Gastrointestinal Surgeons | es |
dc.description.sponsorship | Bowel Disease Research Foundation | es |
dc.description.sponsorship | Yorkshire Cancer Research | es |
dc.description.sponsorship | Sarcoma UK | es |
dc.description.sponsorship | British Association of Surgical Oncology | es |
dc.description.sponsorship | Vascular Society for Great Britain and Ireland | es |
dc.format | application/pdf | es |
dc.format.extent | 19 | es |
dc.language.iso | eng | es |
dc.publisher | BMJ | es |
dc.relation.ispartof | BMJ Open, 11 (11), 1-19. | |
dc.rights | Atribución 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | * |
dc.subject | SARS-CoV- 2 infection | es |
dc.subject | Proximal femoral fracture | es |
dc.subject | Patients undergoing surgery | es |
dc.subject | Preoperative counselling | es |
dc.title | Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: An international cohort study | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Cirugía | es |
dc.identifier.doi | 10.1136/bmjopen-2021-050830 | es |
dc.contributor.group | Universidad de Sevilla. CTS544: Grupo de Investigación Oncológica colorrectal y Cirugía General y Digestiva | es |
dc.contributor.group | Universidad de Sevilla. CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la cirugía | es |
dc.contributor.group | Universidad de Sevilla. CTS406: Estudio de Enfermedades Infecciosas en la Práctica Clínica | es |
dc.journaltitle | BMJ Open | es |
dc.publication.volumen | 11 | es |
dc.publication.issue | 11 | es |
dc.publication.initialPage | 1 | es |
dc.publication.endPage | 19 | es |