Try a new search

Format these results:

Searched for:

person:browna66

in-biosketch:true

Total Results:

3


Initiating advance care planning at admission: a brief intervention to increase goals of care discussions in geriatric trauma patients in an urban level I trauma center

Hwang, Franchesca; Son, Joohee; Ensor, Kelsey; Goulet, Nicole; Brown, Allison; Victory, Jesse; Tyrie, Leslie
OBJECTIVES/UNASSIGNED:The burden of geriatric trauma continues to rise. Older trauma patients experience higher morbidity and mortality and thus benefit from early goals of care (GOC) discussions and advance care planning (ACP). The American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) recommends holding a family meeting within 72 hours of admission when treating geriatric trauma patients. At our level I trauma center, we sought to increase early GOC discussions by implementing a new history and physical (H&P) note template for geriatric trauma patients. METHODS/UNASSIGNED:Patients (aged >65 years) admitted to the trauma surgery service (≥24 hours) were included in the study. The intervention was a change in the H&P note template to include confirmation of code status or previous ACP and identification of a healthcare proxy. Primary outcomes were the rates of recognizing a pre-existing Do-Not-Resuscitate (DNR) status/advanced directives at admission and of documentation of a GOC discussion within 72 hours. Outcomes from a 3-month period (March-May) during the pre-intervention (2021) and post-intervention (2022) periods were compared. RESULTS/UNASSIGNED:The pre-intervention and post-intervention groups had 107 and 150 patients, respectively. We observed an increase in recognition of pre-existing DNR code status at time of admission from 50% to 95% (p=0.003) and documentation of a GOC discussion within 72 hours from 17% to 83% (p<0.0001). We also observed a trend showing that new DNR orders were placed more frequently in the post-intervention period (9% vs 17%, p=0.098). The in-hospital mortality was not significantly different. CONCLUSIONS/UNASSIGNED:The importance of GOC discussions and ACP documentation for geriatric trauma patients is evident, but its completion can be challenging. Our intervention of a new H&P note template increased GOC discussions, and this implementation may be feasible in other trauma centers to comply with the ACS-TQIP Geriatric Trauma Management Guidelines. LEVEL OF EVIDENCE/UNASSIGNED:Level III.
PMCID:10660418
PMID: 38020856
ISSN: 2397-5776
CID: 5617502

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Aaraj, Mahmoud A; Abate, Emmanuele; Abbott, Sarah J; Abbott, Tom Ef; Abdalaziz, Hossam; Abdalla, Mutwakil Om; Abdelaal, Ahmed S; Abdelkarim, Mostafa; Abdou, Hossam; Aboelkassem-Ibrahim, Ahmad; Abou Chaar, Mohamad K; Abuown, Ala; Acebes-Garcia, Fernando; Acharya, Metesh; Adamina, Michel; Addae-Boateng, Emmanuel; Ademuyiwa, Adesoji O; Aftab, Raiyyan; Agarwal, Arnav; Aguilar, José; Aherne, Thomas M; Ahmed, Yousra; Aitken, Emma; Al Maadany, Faraj S; Al-Azzawi, Marwa; Al-Embideen, Somya; Al-Masri, Mahmoud; Al-Najjar, Hani; Al-Sukaini, Ahmad; Alakaloko, Felix; Alam, Ruhina; Alameer, Ehab; Alanbuki, Ammar; Alderson, Derek; Ali Karar, Ali A; Ali, Inthekab Ali Mohamed; Ali, Osman M; Aliyeva, Zumrud; Aljanadi, Firas; Alkadeeki, Ghadah Z; Almasri, Murad; Almeida, Ana C; Alonso-Ortuño, Paula; Alrahawy, Mahmoud M; Alser, Osaid; Altintoprak, Fatih; Alvarez, Maria R; Ambler, Graeme K; Amira, Gamal; Amjad, Rabbia; Anania, Gabriele; Andabaka, Tatjana; Andreani, Stefano M; Angelou, Dimitrios; Annamalai, Seethalakshmi; Annessi, Valerio; Anthoney, James; Antonanzas, Leyre Lopez; Anwar, Sibtain; Anwer, Mariyah; Aoun, Salah G; Aragon-Chamizo, Juan; Archer, James E; Ardito, Antonella; Arigoni, Michele; Armao, Teodora; Arminio, Armando; Armstrong, Lara; Arnaud, Alexis; Arnaud, Alexis P; Asaad, Peter; Ashcroft, James; Ashmore, Christopher; Ashoush, Fouad M; Asqalan, Ahmad; Asti, Emanuele; Ataíde Gomes, Gustavo Mendonça; Aubry, Emmanuelle; Augestad, Knut Magne; Avellana, Rocio B; Ayeni, Funbi A; Ayorinde, John Oo; Aytac, Erman; Ayuso-Herrera, Esther; Babu, Bheemanakone H; Baeza, Melody; Baig, Mirza Mas; Bailon-Cuadrado, Martin; Bajomo, Oreoluwa M; Baker, Markus P; Baker, Olivia J; Bakmaz, Bernarda; Bakri, Nur Amalina Che; Baldi, Caterina; Baldini, Edoardo; Baldo, Stefano; Baldwin, Alexander J; Ballabio, Michele; Baloyiannis, Ioannis; Baltazar, Gerard; Ban, Vin Shen; Bandiera, Alessandro; Bankhead-Kendall, Brittany K; Barlow, Emma; Barmasse, Roberto; Barmpagianni, Christina; Baron, Ryan D; Baronio, Gianluca; Barra, Fabio; Barranquero, Alberto G; Barry, Conor P; Bartsch, Anne-Marie; Basgaran, Amedra; Basha, Amr; Bashkirova, Varvara; Bass, Gary A; Bastazza, Marco; Bath, Michael F; Batjer, H Hunt; Baumber, Rachel; Bauset, Juan Carlos Catalá; Beamish, Andrew J; Belcher, Elizabeth; Belgaumkar, Ajay P; Beltrán de Heredia, Juan; Belvedere, Angela; Bence, Matthew N; Benson, Ruth A; Benítez-Linero, Inmaculada; Bergeat, Damien; Bernal-Sprekelsen, Juan Carlos; Bernasconi, Matteo; Bhalla, Ashish; Bhama, Anuradha R; Bhangu, Aneel; Bhavaraju, Avi V; Bhutiani, Neal; Bianco, Federica; Biffl, Walter L; Bisagni, Pietro; Blake, Iain; Blanco-Colino, Ruth; Blas Laina, Juan Luis; Blazer Iii, Dan G; Blazquez-Martin, Alma; Blundell, Chris M; Boal, Matthew; Boddy, Alexander P; Bonavina, Giulia; Bonavina, Luigi; Bond-Smith, Giles; Booth, Karen; Borges, Filipe; Borghi, Felice; Borgstein, Alexander Bj; Borja De Lacy, F; Bosanquet, David C; Bosch, Karen D; Bouchagier, Konstantinos; Bouhuwaish, Ahmad Em; Bourke, Grainne; Boyle, Emily; Bozkurt, Mehmet A; Brachini, Gioia; Brain, Jessie; Brar, Amanpreet; Brathwaite, Collin Em; Breckles, Lisa; Breen, Kerry A; Bretagnol, Frédéric; Brixton, Genevieve; Brown, Allison K; Brown, Benjamin C; Brown, Oliver D; Bruzzaniti, Placido; Buarque, Igor Lima; Bueno-Cañones, Alejandro D; Bueser, Teofila; Bulugma, Mustafa R; Burke, Joshua R; Burnside, Nathan; Byrne, Matthew Hv; Bàmbina, Fabrizio; Caballero, Albert; Cagigal-Ortega, Elima P; Calcerrada-Alises, Enrique; Callahan, Miriam; Callcut, Rachael A; Camarero, Enrique; Campagnaro, Tommaso; Campanelli, Michela; Candiani, Massimo; Cannoletta, Maria; Canova, Michaela E; Cantalejo-Diaz, Miguel; Cao, Han; Capelli, Patrizio; Capitan-Morales, Luis-Cristobal; Capizzi, Vita; Carcano, Giulio; Carissimi, Francesca; Carlini, Massimo; Carlos, William J; Carlucci, Michele; Carmichael, Heather; Carrasco, Milagros; Carrillo, Mariana; Caruana, Edward J; Carvello, Michele; Casati, Massimiliano; Castoro, Carlo; Catalan, Vanesa; Cato, Liam D; Catton, Andrew B; Cavaleiro, Salomé; Cellerino, Paola; Centinaio, Giovanna; Ceretti, Andrea Pisani; Cernei, Cristina; Cerro, Cristina; Cervellera, Maurizio; Chakrabortee, Sohini; Chamberlain, Stephanie; Chan, Jeffrey; Chang, Grace; Chase, Thomas Jg; Chaudhry, Dauod; Chebaro, Alexandre; Chen, David; Chetty, Govind; Chia, Zoe; Chiappini, Ambra; Chiara, Francesco Di; Chiarugi, Massimo; Chidambaram, Swathikan; Chiozza, Matteo; Cholewa, Hanna; Chong, Clara; Choolani-Bhojwani, Ekta; Chowdhury, Abeed H; Chrastek, David; Christoforidis, Dimitri; Chui, Karen; Chung, Choyin; Chung, Eric A; Cicerchia, Pierfranco M; Cirillo, Bruno; Citterio, Davide; Clermidi, Pauline; Clough, Ethan Cs; Coccolini, Federico; Coleman, Natasha L; Colletti, Gaia; Collins, Chris G; Collins, Michelle L; Colonna, Emily T; Comini, Lara V; Compagnoni, Bruno; Concepción-Martín, Vanesa; Confalonieri, Marco; Connelly, Tara M; Connolly, Hannah; Conso, Christel; Conti, Luigi; Cooper, Zara; Corbellini, Carlo; Cordera, Fernando; Corral, Javier; Costa, Marta; Costa, Paulo Matos; Costanzi, Andrea; Cotsoglou, Christian; Coughlin, Patrick A; Cox, Daniel; Cozza, Valerio; Cruzado, Laura Fernández-Gomez; Cuming, Tamzin; Cunha, Miguel F; Curtis, Miles; Cuschieri, Joseph; D'Agruma, Michele; D'Andrea, Giancarlo; Da Roit, Anna; Daliya, Prita; Dare, Oliver; Darko, Ebenezer; Dass, Debashis; Davidson, Brian R; Davidson, Giana H; Davies, Emma J; Davies, Richard J; Davis, Niall F; Dawson, Brett E; Day, Andrew; De Andrés-Asenjo, Beatriz; de Gheldere, Charles A; De Marchi, Joshua A; De Miguel-Ardevines, Maria-Carmen; De Nardi, Paola; De Salas, Maria Marqueta; De Simone, Veronica; De Souza, Anthony C; De Toma, Giorgio; De Virgilio, Armando; de Vries, Jean-Paul Pm; Dean, Benjamin Jf; Dean, Harry; Dehal, Ahmed; Dehart, Dustin; Del Giudice, Roberto; Delgado, Maria Garcia-Conde; Delgado-Oliver, Eduardo; Denning, Max; Desai, Anant; Desender, Liesbeth; Dester, Sara; DI Bartolomeo, Alessandro; DI Candido, Francesca; Di Franco, Gregorio; Di Giuseppe, Matteo; Di Saverio, Salomone; Diaz, Jose J; Diaz-Peña, Patricia; Dickson, Kathryn E; Diez-Alonso, Manuel M; Dixon, Jan R; Doe, Matthew J; Dolores Del Toro, M; Dousset, Bertrand; Doussot, Alexandre; Drake, Frederick T; Drake, Thomas D; Duchateau, Nicolas; Duff, Sarah; Duffy, John P; Dunne, Declan Fj; Dunne, Naomi Jm; Dunning, Joel; Duque-Mallen, Victoria; Durst, Alexander Ze; Durán-Muñoz-Cruzado, Virginia M; Dziakova, Jana; Díaz Pérez, David; Díaz-García, Alberto; Eardley, Nicola J; Edwards, John G; Egan, Bridget; Egan, Richard; El Kassas, Mohamed; El Youzouri, Hanan; El-Ali, Abess; Elfallal, Ahmed H; Elfeki, Hossam; Elfiky, Mahmoud Ma; Elhadi, Muhammed; Eljareh, Mohammed; Elkadi, Hannah H; Elkady, Ramy; Elkhafeefi, Fatimah; Elliott, Jessie A; Elmore, Ugo; Elmoslemany, Tarek; Emile, Sameh H; Emmerson, Oliver; Emslie, Katy M; Endorf, Frederick W; Enemosah, Ibrahim; Engel, Jamie L; English, Camilla; English, William; Enjuto, Diego T; Erridge, Simon; Escartin, Jorge; Estaire-Gomez, Mercedes; Etchill, Eric W; Evans, Jessica; Evans, Jonathan P; Evans, Luke; Exley, Rebecca; Fabbri, Nicoló; Fahey, Brian A; Falco, Giuseppe; Familiari, Pietro; Fancellu, Alessandro; Faria, Carlos S; Farik, Shebani; Farrell, Tony; Fehervari, Matyas; Fell, Adam; Feo, Carlo V; Ferguson, Henry Jm; Fernandez, Andres Garcia; Fernandez, Beatriz Dieguez; Fernandez-Camuñas, Angel; Fernández, Antonio J; Fernández-Martínez, María; Fernández-Marín, Reyes; Fernández-Pacheco, Borja Camacho; Ferrara, Francesco; Ferrari, Guglielmo; Ferrero, Simone; Findlay, Laura; Fiore, Marco; Fiori, Enrico; Fitzgerald, J Edward; Flatman, Michael; Flindall, Ian; Flor, Blas; Fonsi, Giovanni B; Font, Roser Farré; Fontana, Tommaso; Ford, David; Ford, Samuel; Forlani, Stefano; Fowler, Amy L; Francone, Elisa; Frattaruolo, Colomba; Fretwell, Kenneth R; Frio, Federico; Fructuoso, Lorena Sanchon; Fusai, Giuseppe K; Gagliano, Annalisa; Gagliardi, Filippo; Gahunia, Sukhpreet; Gaino, Francesca; Gala, Tanzeela; Galfrascoli, Elisa; Galimberti, Luca; Galindo Jara, Pablo; Gallagher, Phoebe; Galleano, Raffaele; Gallo, Gaetano; Galván-Pérez, Armando; Gammeri, Emanuele; Ganau, Mario; Garcia Galocha, Jose L; Garcia, Miguel Hernandez; Garcia-Ureña, Miguel Angel; Garcés-García, Raúl; Gardner, Anne; Garulli, Gianluca; Gascon-Ferrer, Isabel; Gattolin, Andrea; Gaujoux, Sebastien; Gentilli, Sergio; Georgiades, Fanourios; Ghanbari, Amir; Ghosh, Dhruv; Giacometti, Marco; Giblin, Anna-Victoria; Gilbert, Catherine; Gill, Charn K; Giménez, Clara; Giorgakis, Emmanouil; Gipponi, Manuel; Gisbertz, Suzanne S; Giuffrida, Maria Carmela; Glasbey, James C; Glen, Paul; Goatly, Giles; Gobatti, Davide; Godbole, Chintamani; Gohil, Kajal; Gomez-Rosado, Juan-Carlos; Gonullu, Emre; Gonzalez-De Miguel, Melania; Gonzalez-Gonzalez, Enrique; Gordini, Luca; Gracia, Isabel; Gracia-Roche, Carlos; Granieri, Stefano; Green, Susanna; Gregg, Anne; Griffiths, Ewen A; Grivon, Manuela; Grove, Thomas; Guaglio, Marcello; Guaitoli, Eleonora; Guariglia, Claudio A; Guglielmi, Alfredo; Guha, Soumya; Gujjuri, Rohan R; Gustavino, Claudio; Gutiérrez Samaniego, María; Gómez Díaz, Carlos J; Gómez, Marcos; Gómez, María Fanjul; Habeeb, Amir; Hagger, Robert; Hainsworth, Alison J; Hakmi, Hazim; Halkias, Constantine; Hall, Bria J; Hall, Claire; Hall, James Rw; Hammond, John S; Hampton, Matthew; Handa, Siddhartha; Hansen, Laura; Haq, Iram; Haqqani, Maha H; Harky, Amer; Harries, Rhiannon; Harrison, Ewen M; Harrison, Joseph; Hasan, Raashad; Hawari, Mohammad; Hawkin, Paul; Hazelton, Joshua P; Hebblethwaite, Bethany; Henriques, Susana; Heritage, Emily; Hernandez-Juara, Pilar; Hernández Bartolomé, Miguel Ángel; Herrero-Lopez, Maria; Hervieux, Erik; Heyd, Bruno; Higgs, Simon; Hill, Arnold Dk; Hing, Caroline B; Hirji, Sameer A; Hitchman, Louise; Ho, Beatrice; Ho, Michael Ws; Hogan, Aisling; Holbrook, Charlotte M; Holme, Thomas J; Hopkins, James C; Hopkinson, David N; Hossain, Fahad S; Hossain, Tanvir; Houston, Rory; Hudson, Victoria E; Hughes, Jane L; Hurt, Libor; Hutchinson, Peter; Hutchinson, Peter J; Hwang, E Shelley; Hölzle, Frank; Iacob, Giulio; Iannone, Immacolata; Ibrahim, Mohamed Ah; Ibrahim, Sherif; Iovino, Domenico; Irvine, Esmee; Isik, Arda; Isolani, Simone M; Jafarova, Sevda; Jamil, Tahir; Jayaraju, Ullas; Jeganathan, Reuben; Jenkinson, Michael D; Jenner, Edward; Jenny, Hillary E; Jeyaretna, Deva S; Jiao, Long R; Jimenez-Higuera, Elisa; Jimeno, Jaime; Johnstone, Jack R; Jones, Andrew P; Jones, Gareth P; Jones, Mark; Jones, Robert P; Jonker, Pascal Kc; Joyce, Doireann P; Judkins, Nicholas; Jönsson, Maria L; Kaafarani, Haytham Ma; Kalavrezos, Nicholas; Kalidindi, Venugopala; Kalkat, Maninder; Kalkwarf, Kyle J; Kamal, Mona; Kamarajah, Sivesh K; Kamphues, Carsten; Kang, Chong; Kara, Yasin; Karam, Edward; Karim, Ahmed; Kashora, Florence; Kaushal, Manish V; Kavanagh, Dara O; Kearney, David; Keatley, James M; Keller, Deborah S; Khajuria, Apoorva; Khalefa, Mohamed A; Khan, Azam; Khan, Jim S; Khan, Umul; Khatri, Chetan; Kinnaman, Gabriel; Kinross, James; Kirmani, Bilal H; Kisiel, Aaron P; Kler, Aaron; Klimopoulos, Serafeim; KocataÅŸ, Ali; Kolias, Angelos; Konsten, Joop; Kontovounisios, Christos; Kourdouli, Amar; Kouris, Spyros Marinos; Kouritas, Vasileios; Kowal, Mikolaj R; Krishnan, Emily; Kristinsson, Sverrir; Kruijff, Schelto; Kudsk-Iversen, Søren; Kufeji, Dorothy; Kugler, Nadav; Kulkarni, Gauri; Kulkarni, Rugved; Kurihara, Hayato; Königsrainer, Alfred; La Torre, Filippo; Labib, Peter L; Laface, Letizia; Lakkis, Zaher; Lami, Mariam; Landaluce-Olavarria, Aitor; Lapolla, Pierfrancesco; Larkin, John O; Lauscher, Johannes C; Lawani, Ismail; Lawday, Samuel; Le Roy, Bertrand; Leclercq, Wouter Kg; Lecolle, Katia; Lederhuber, Hans; Ledesma, Frances Sj; Leite-Moreira, André M; Leo, Cosimo Alex; Leung, Elaine Yl; Leventoglu, Sezai; Lewis, Sophia E; Li, Elizabeth; Li, Zoe; Liew, Ignatius; Lima, Maria João; Lin, Daniel J; Lisi, Giorgio; Liu, Helen H; Liyanage, Aloka S D; Lizzi, Vincenzo; Lo, Terence; Lombardi, Celestino P; Lomiento, Daniele; Longhi, Marco; Lostis, Emilie; Lostoridis, Eftychios; Loubani, Mahmoud; Lowery, Aoife J; Lowy-Benoliel, Alejandro; Lozano, Saida Martel; Lucianetti, Alessandro; Luke, Louis; Lunevicius, Raimundas; Luney, Catriona R; Luraghi, Marco; Lye, George; Lázaro, André; Löffler, Markus W; Mabrouk, Islam; Macchi, Alberto; MacDonald, Luisa; Machairas, Nikolaos; Madonini, Marco; Magowan, Drew; Maia, Mariana Magalhães; Maisonneuve, Emeline; Majkowska, Agata; Majkowski, Lawrence; Mak, Jason; Malabarba, Stefano; Malerba, Michele; Mannan, Syed; Manson, Joanna; Mansuri, Ahmer; Mantoglu, Baris; Manu, Nichola; Maqsood, Afnan; Marano, Alessandra; Marchbank, Adrian; Marcos-Santos, Pablo; Mari, Giulio Maria; Mariani, Nicolò M; Marino Cosentino, Luigi Mp; Marino, Marco V; Marra, Angelo A; Marrano, Enrico; Marsh, Christopher L; Martin, Benjamin; Martin, Emmeline; Martin, Guy; Martin, Janet; Martin, Robert Cg; Martin-Albo, Lorena; Martinelli, Fabio; Martinez-German, Antonio; Martinez-Pinedo, Carlos; Martins, Ricardo; Martín-Román, Lorena; Martínez-dePaz, Fernando; Martínez-Pérez, Carolina; Marwan, Hisham; Marzi, Federica; Mashbari, Hassan N; Mateo-Sierra, Olga; Mathieu, Pierre; Matute-Najarro, Maria-Soledad; Maw, Andrew; Mazingi, Dennis; Mazzaferro, Vincenzo; McCanny, Andrew; McCluney, Simon J; McIntyre, Robert C; Mckay, Siobhan C; McKenzie, Katherine; McKevitt, Kevin L; McLarty, Nicola; McPherson, Iain; Meagher, Ashley D; Medina, Esther; Mediratta, Saniya; Medone, Marzia; Mehdi, Mohammad Q; Mehigan, Brian J; Mehra, Gautam; Mele, Simone; Melero-Cortés, Lidia; Mendoza-Moreno, Fernando; Meneghini, Simona; Mercante, Giuseppe; Merdrignac, Aude; Merola, Stephen; Metallidis, Symeon; Michel, Martin; Migliore, Marco; Mihanovic, Jakov; Miller, Douglas; Mills, Sarah J; Minaya-Bravo, Ana; Mingoli, Andrea; Minto, Gary; Mirabella, Antonello; Misra, Nikhil; Mithany, Reda H M; Mitrasinovic, Stefan; Miu, Victor; Moawad, Nader; Mochet, Sylvie; Modabber, Ali; Mohammad, Adam; Mohan, Helen M; Mohan, Midhun; Moir, John Ag; Moliner-Sánchez, Carmen; Mongelli, Francesco; Monson, John Rt; Monteiro, Joana M; Monteleone, Michela; Montella, Maria T; Montesinos, Cristina Soto; Montuori, Mauro; Moore, Rachel; Mora-Guzmán, Ismael; Morales, Dieter; Morales, Xavier; Morelli, Luca; Morelli, Lucia; Morgan, Richard; Morgom, Marwa M; Morris, Chris; Mortini, Pietro; Morton, Dion G; Mosca, Angelo; Moszkowicz, David; Motter, Dema; Moug, Susan; Moura, Francisco S; Muguerza, Jose M; Mukherjee, Samrat; Murphy, Suzanne H; Najdy, Manhal; Nakas, Apostolos; Namazov, Ilgar; Naredla, Pradyumna; Nasef, Emmhamed; Nassa, Heeam; Nath, Rahul; Naumann, David N; Navarro-Sánchez, Antonio; Nazarian, Scarlet; Neary, Paul C; Neely, David Ta; Negri, Giampiero; Nehra, Deepika; Neil-Dwyer, Jason; Nepogodiev, Dmitri; Neri, Jacopo; Newton, Katy; Ng-Kamstra, Joshua S; Ngu, Albert Wt; Nguyen, Truong A; Nikaj, Herald; Niquen, Milagros; Nita, George E; Nizami, Kulsoom; Nobile, Sara; Nogueiro, Jorge; Ntirenganya, Faustin; Nugent Iii, William C; Nugent, Michael; Nunes, Quentin M; Nygaard, Rachel M; Núñez, Jordi; O'Meara, Lindsay B; O'Neill, John R; Ocaña, Juan; Odeh, Abdulrahman; Okafor, Barbara U; Okechukwu, Valentine; Oliva-Mompean, Fernando; Oliveira, Ana; Ollat, Didier; Olson, Steven A; Omar, Omar M; Onos, Lavinia; Oo, Aung Y; Ormazabal, Pablo Collera; Osagie-Clouard, Liza; Osman, Khabab; Osorio, Alexander L; Ottolina, Jessica; Ourieff, Jared; Outani, Oumaima; Oyewole, Bankole; Ozben, Volkan; Pacheco-Sanchez, David; Pachl, Max J; Padilla-Valverde, David; Pai, Madhava; Paiella, Salvatore; Paisley, Samuel; Palini, Gianmarco; Palmeri, Matteo; Panahi, Pedram; Parente, Alessandro; Parlanti, Daniele; Parmar, Chetan; Parry, James T; Pascual, Angela; Pata, Francesco; Patel, Mahul; Patel, Panna K; Pathak, Abhijit; Patil, Sangram; Pattyn, Piet; Peckham-Cooper, Adam; Pedrazzani, Corrado; Pellino, Gianluca; Peluso, Chiara; Pereira, André; Pereira-Neves, António; Perez-Diaz, M D; Perivoliotis, Konstantinos; Perkins, Clare; Peros, Georgios; Perotto, Ornella; Perra, Teresa; Petrone, Patrizio; Pevidal, Ana Nogues; Pezzuto, Anna P; Phenix, George; Philp, Matthew M; Picazo, Sara; Picon-Rodriguez, Rafael; Piloni, Martina; Pingarrón-Martín, Lorena; Pinkney, Thomas D; Pinotti, Enrico; Pisanu, Adolfo; Pizzini, Paolo; Pockney, Peter; Podda, Mauro; Podolsky, Dina; Poggioli, Gilberto; Pollok, Joerg M; Pompili, Cecilia; Pontari, Michael; Porcu, Alberto; Potter, Ryan; Povey, Meical G; Poza, Alfredo Alonso; Price, Claire; Pruvot, François-René; Pujol-Muncunill, Roger; Puppo, Andrea; Pérez-González, Marta; Pérez-Saborido, Baltasar; Pérez-Sánchez, Luis E; Quante, Markus; Quintana-Villamandos, Begoña; Qureshi, Ali; Radenkovic, Dejan; Rajgor, Amarkumar D; Rakvin, Ivan; Ramallo-Solís, Irene; Ramcharan, Sean; Ramos, Diego; Ramos-Bonilla, Antonio; Ramos-De la Medina, Antonio; Ramzi, Joussi; Rao, Jagan N; Raptis, Dimitri A; Rathinam, Sridhar; Rausa, Emanuele; Ravaioli, Matteo; Ravindran, Sharanya; Raymond, Thomas; Razik, Aisha; Redfern, Jennifer; Reguera-Rosal, Julio; Rela, Mariam; Rey-Biel, Juan; Rey-Valcarcel, Cristina; Ribolla, Marta; Rice, Henry E; Richards, Tomos; Richmond, Michael; Ridgway, Paul F; Righini, Erminio; Rio-Gomez, Javier; Rivas, Ana Munoz; Riyat, Harjoat; Rizvi, Sana; Roberts, Keith; Roberts, Matthew; Robertson, Ronald; Robertson, Stuart; Robin-Valle, Alvaro; Rochon, Melissa; Rodriguez-Sanjuan, Juan C; Rogers, Luke J; Rojo, Mikel; Rollett, Rebecca A; Rolli, Luigi; Romano, Silvio; Romera, Jose L; Rooney, Siobhan M; Rosato, Francesco; Roslani, April C; Ross, Elizabeth; Ross, Howard; Rossborough, Catherine; Rottoli, Matteo; Roxo, Vanessa I; Rubio, Eduardo E; Ruiz, Carolina Castro; Ruiz, Manuel Losada; Ruiz-Grande, Fernando; Ruiz-Marin, Miguel; Ruiz-Martin, Irene; Ruiz-Soriano, María; Ruzzenente, Andrea; Ryan, Éanna J; Ryska, Ondrej; Saad, Abdel Rahman; Saeed, Samerah A; Saez, Carlos; Sagnotta, Andrea; Sahnan, Kapil; Sahni, Arun; Salama, Hiba A; Salamah, Abdulrauf A; Salem, Hosni Khairy; Salim, Ali; Sallam, Ibrahim; Salvia, Roberto; Samadov, Elgun; Sammarco, Giuseppe; Sampaio-Alves, Mafalda; Sampietro, Gianluca M; San Miguel Mendez, Carlos; Sanchez Del Pueblo, Cristina; Sanchez-Fuentes, Maria-Nieves; Sanchez-Pelaez, Daniel; Sanchez-Perez, Coral; Sanchez-Rubio, Maria; Sancho-Muriel, Jorge; Sanders, Julie; Santero-Ramirez, Maria-Pilar; Santora, Thomas; Santoro, Antonio; Santos, Irene; Santos-Sousa, Hugo; Sapienza, Paolo; Sarma, Diwakar R; Sartarelli, Lodovico; Sarveswaran, Janahan; Sasia, Diego; Saudemont, Alain; Saudi-Moro, Sef; Saxena, Dolly; Saxena, Shobhit; Sayasneh, Ahmad; Scalabre, Aurelien; Schache, Andrew; Schaffer, Kathryn B; Schiavina, Riccardo; Schilling, Clare; Schineis, Christian; Schnitzbauer, Andreas A; Schreckenbach, Teresa; Scorza, Antonella; Scott, Lucy; Scurrah, Rachel J; Seegert, Sara; Seguin-Givelet, Agathe; Senent-Boza, Ana; Serevina, Olivia L; Serralheiro, Pedro A; Serrano González, Javier; Sewards, Joseph M; Seymour, Keith; Shabana, Amanda; Shackcloth, Michael J; Shah, Jigar; Shah, Karishma; Shah, Preena; Shah, Sujay; Shakir, Taner; Shalaby, Mostafa; Shane Lester, Madan Jha; Shankar, Sushma; Sharma, Neil; Shaw, Abigail V; Shaw, Richard; Sheel, Andrea Rg; Shehata, Sameh; Shenfine, Amy; Sheridan, Kelda; Sherief, Ahmed; Sherief, Mohamed; Sherif, Mohamed; Shinkwin, Michael; Shu, Sebastian; Siaw-Acheampong, Kwabena; Sica, Giuseppe S; Siddique, Muhammad Harris; Sileri, Pierpaolo; Simoes, Joana Ff; Singh, Abhinav; Singh, Aminder A; Singh, Rabindra P; Singh, Shailendra; Sinha, Deepti; Sinha, Sanjay; Siragusa, Leandro; Sivaprakasam, Rajesh; Sivayoganathan, Sriharan; Skelly, Brendan L; Smart, Neil J; Smillie, Robert; Smith, Andrew; Smith, Christopher; Smith, Claire; Smith, Henry G; Sochorova, Dana; Soggiu, Fiammetta; Sohail, Amir H; Sohrabi, Catrin; Solari, Francesca; Solli, Piergiorgio; Soreide, Kjetil; Spalding, Duncan R; Spinelli, Antonino; Spoletini, Domenico; Spriano, Giuseppe; Springford, Laurie R; Sravanam, Sanskrithi; Ssentongo, Anna E; Ssentongo, Paddy; Stanger, Sophie; Stavroulias, Dionisios; Steel, Ben; Steinkamp, Pieter J; Stella, Marco; Stevens, Kent A; Stewart, Grant D; Stewart, Robbie; Stringer, Sally; Stylianides, Nicholas A; Sulen, Nina; Sullivan, Tom Bb; Sundar, Sudha; Sundhu, Matthew; Suri, Avni; Syed, Arooj; Szatmary, Peter; Sánchez-Arteaga, Alejandro; Tabiri, Stephen; Tadross, Daniel; Taglietti, Lucio; Taher, Ahmed Sa; Tamimy, Muhammad S; Tang, Alethea M; Tansey, Rosamond; Tartaglia, Dario; Tawheed, Ahmed; Tayeh, Salim; Tebala, Giovanni D; Tejero-Pintor, Francisco J; Teles, Tobias; Testa, Valentina; Tewari, Nilanjana; Thaha, Mohamed A; Thoenissen, Philipp; Thomas, Amy J; Thomas, Kane; Thomin, Anne; Thrush, Jessica; Tierney, Sean; Tiwari, Abhinav; Toh, Simon; Toledo, Enrique; Tonini, Valeria; Torkington, Jared; Torquati, Alfonso; Torres, Antonio J; Torzilli, Guido; Totty, Joshua; Tourountzi, Paraskevi; Tousidonis, Manuel; Townend, Philip; Townsend, Catherine; Townshend, David N; Tripathi, Shiva S; Trompeter, Alex; Trompetto, Mario; Trotta, Francesco; Trout, Isobel M; Truant, Stéphanie; Trujillo-Díaz, Jeancarlos; Tsoulfas, George; Tsoulfas, Georgios; Tucker, Sarah C; Turco, Celia; Turrado-Rodriguez, Victor; Turri, Giulia; Tustin, Harry; Tyler, Jayne; Tzedakis, Stylianos; Tzovaras, George; Ubhi, Harmony K; Uittenbogaart, Martine; Ullah, Ramzan; Urban, Shane; Urbani, Alessia; Usai, Antonella; Vaccarella, Gianpaolo; Valdes-Hernandez, Javier; Valsecchi, Luca; van Berge Henegouwen, Mark I; van der Plas, Willemijn Y; van Heinsbergen, Maarten; van Ramshorst, Gabrielle H; Vashisht, Rajiv; Vega, Viviana A; Velmahos, George C; Velopulos, Catherine G; Venkatesan, Gowtham S; Venn, Mary; Venn, Mary L; Vera-Mansilla, Cristina; Vergari, Roberto; Vescio, Giuseppina; Vidya, Raghavan; Vieira, Paula; Vijay, Vardhini; Vimalachandran, Dale; Violante, Tommaso; Viswanath, Yirupaiahgari Ks; Vivas, Alfredo A; Volpe, Anita; Vovola, Fernanda; Vulliamy, Paul; Vázquez-Fernández, Andrea; Wade, Ryckie G; Wadley, Martin S; Wall, Joshua Js; Wall, Rosemary; Wallwork, Kate; Walsh, Stewart; Walters, Andrew M; Ward, Alex; Warren, Oliver J; Warwick, David; Waseem, Saima; Weaver, Helen; Weerasinghe, Chamindri K; Wells, Fiona; Wen, Jiaxin; West, Raha; Whitehall, Emma; Wild, Laura; Wilkin, Richard Jw; Wilkins, Alex; Williams, Gethin; Williams, Katherine J; Williams, Matthew; Winnand, Philipp; Winter, Stuart C; Wong, Ken; Worku, Dawit; Wormald, Justin Cr; Wright, Franklin L; Wright, Naomi; Xyda, Souzana E; Yalamanchili, Seema; Yershov, Danylo; Yildiz, Alp; Young, Alastair L; Young, Richard; Youssef, Mina Mg; Yousuf, Farhat B; Yurttas, Can; Zadegan, Frederic; Zafar, Noman; Zakaria, Rasheed; Zambon, Martina; Zanini, Nicola; Zappa, Marco A; Zarate, Alba; Zerbib, Philippe; Zizzo, Maurizio; Zmora, Oded; Zonta, Sandro
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<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65-3·22], p<0·0001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (2·35 [1·57-3·53], p<0·0001), 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.
PMID: 32479829
ISSN: 1474-547x
CID: 4851402

Population Coverage of Trauma Systems: What Do Helicopters Add?

Smedley, W Andrew; Stone, K Lorraine; Killian, John; Brown, Allison; Farley, Paige; Griffin, Russell L; Cox, Daniel B; Kerby, Jeffrey D; Jansen, Jan O
Trauma is a time-critical condition. Helicopters are thought to enhance the accessibility to trauma centers, but this benefit is poorly quantified. The aim of this study was to conduct a geographical analysis of the added benefit provided by helicopters, over ground transport. This study uses geospatial analysis. Helicopter bases and Level I and II designated trauma centers were geocoded. 60-minute drive-time and elliptical flight-time isochrones were mapped with ArcGISâ„¢ (Esri, Redlands, CA). Calculations included allowance for mission ground time (MGT). We compared the proportion of the population that could be taken to Level I and II trauma centers, within 60 minutes, by road and by air. Using a 30-minute MGT model, helicopters permit 279,317 additional residents (5.8%) access to a Level I trauma center within 60 minutes. Using the 20-minute MGT model, 1,089,177 more residents (22.8%) would have access to Level I trauma center care. The benefits were marginally greater for access to Level I and II trauma center care. Helicopters enhance access to specialist trauma center care, but the benefit is small and dependent on MGT. Consideration should be given to the siting of helicopters, particularly in relation to trauma patients, MGT, and the timely response of EMS when determining the triage for helicopter transport.
PMCID:8011580
PMID: 31638527
ISSN: 1555-9823
CID: 5030512