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Papers by Sachin kale

Journal of clinical orthopaedics, 2023

Journal of clinical orthopaedics, 2023

Journal of Clinical Orthopaedics

Introduction: Burnout is a syndrome denoting the outcome of chronic work stress which has not bee... more Introduction: Burnout is a syndrome denoting the outcome of chronic work stress which has not been managed successfully. Burnout has only sometimes been at the forefront of studies in healthcare, where patient care and management have received more attention. This study focuses particularly on burnout of residents and healthcare workers during the COVID-19 pandemic that has changed the working environment. Material and Methods: Questionnaires in the form of surveys have been used to receive feedback regarding work experience within the bubble of isolation and high patient load unique to COVID-19 pandemic. A full and complete analysis of the research is provided after the definition, description, and measurement of burnout are given. Results: According to a review of the burnout literature, burnout affects medical students, residents, and practicing doctors, with prevalence rates ranging from 28% to 45% for each group. First-year residency during the COVID-19 pandemic, in particular,...

MGM Journal of Medical Sciences

The Lancet

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as ind... more Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45•6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84•5 (95% CI 84•1-84•9), which varied between HIC (88•5 [89•0-88•0]), MIC (81•8 [82•5-81•1]), and LIC (66•8 [64•9-68•7]) settings. In the third phase, 1217 (74•6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51•4%) were from HIC, 538 (44•2%) from MIC, and 54 (4•4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3•6% (95% CI 3•0-4•1; p<0•0001) increase in SVR. This was consistent in HIC (4•8% [4•1-5•5]; p<0•0001), MIC (2•8 [2•0-3•7]; p<0•0001), and LIC (3•8 [1•3-6•7%]; p<0•0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs.

Journal of Research and Practice on the Musculoskeletal System

British Journal of Surgery

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The a... more Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains...

International Journal of Research in Orthopaedics

Background: Radiographic imaging in orthopaedic surgical centers is becoming more common, posing ... more Background: Radiographic imaging in orthopaedic surgical centers is becoming more common, posing additional risks to the orthopaedic doctors, who become more exposed to ionising irradiation. As a result, orthopaedic surgeons must have a good understanding of radiation hazards. Despite these issues, many orthopaedic specialists do not get basic radiation safety training. A review of orthopaedic specialists' understanding, awareness, and routine radiation safety practices at an academic hospital in Navi Mumbai. Methods: After institutional ethical approval, a panel of experts created an online survey comprising multiple-choice questions, which was utilized to perform a descriptive research. The questionnaire contained several aspects, each of which assessed orthopaedic understanding, awareness, and practices. The research cohort comprised orthopaedic doctors working through our tertiary medical center and medical college. Results: According to our findings, only 82% of respondents...

International Journal of Research in Orthopaedics

Background: Incidence of ACL injuries and physical parameters like age, sex, height, weight and B... more Background: Incidence of ACL injuries and physical parameters like age, sex, height, weight and BMI has been studied intensely as a risk factor. Each of them poses as a different risk factor for occurrence of ACL injuries. But body-built index-somatotype considers relative proportions of fatness, muscle mass and skeletal architecture in terms of endomorphy, mesomorphy and ectomorphy in a single individual which neutralises variables like age, sex, BMI. Methods: 100 patients were included in the study, excluding those with multiligament injuries, associated fractures around knee, mucoid degeneration of ACL and road traffic accident cases. Parameters such as skin fold thickness, circumference and epicondylar, condylar width was taken into consideration. Body built index was calculated in terms of endomorphy, mesomorphy and ectomorphy using the heath-carter anthropometric somatotype manual. Results: We found that amongst all those have ACL injury, endomorphy was higher grade (5.49), fo...

International Journal of Orthopaedics Sciences, 2020

Femoral neck fractures are rare in children until and unless there is a high energy trauma. This ... more Femoral neck fractures are rare in children until and unless there is a high energy trauma. This paper describes an unusual case of neck of femur fracture in a girl with very low vitamin Dof <4.20 ng/ml successfully managed by open reduction and internal fixation with dynamic hip screw. No clinical or radiological signs of avascular necrosis were observed in four months of follow-up.

Surgical Update: International Journal of Surgery and Orthopedics, 2017

Introduction: Fracture of distal femur and proximal tibial are often difficult to treat and assoc... more Introduction: Fracture of distal femur and proximal tibial are often difficult to treat and associated with many complications. We aimed to assess the clinical and radiological union time and functional outcome in fractures of distal femur and proximal tibia managed by metaphyseal locking plates and to study the complications associated with it. Methodology: This prospective study was conducted from

Journal of Pain and Symptom Management, 2020

Respirology, 2019

radiography findings. These cases eventually had been proven as lung tuberculosis from molecular ... more radiography findings. These cases eventually had been proven as lung tuberculosis from molecular sputum examination. Methods: We evaluated 2 patients were presumptive of lung cancer from radiography findings but had been proven as lung tuberculosis Results: First patient, male, 36 years old referred with, chronic productive cough, breathlessness, right chest pain and weight loss in

Human Vaccines & Immunotherapeutics, 2019

Objectives: To assess the safety and reactogenicity of single oral dose of heat-stable rotavirus ... more Objectives: To assess the safety and reactogenicity of single oral dose of heat-stable rotavirus vaccine (HSRV) in healthy adults aged 18-45 years followed by assessment of safety, reactogenicity, and immunogenicity of three doses of HSRV in healthy infants aged 6-8 weeks at enrollment. Trial Design: Single-center randomized controlled, sequential, blinded (adults) and open-label (infants). Setting: Single site at International Center for Diarrheal Disease Research, Bangladesh (icddr,b). Participants: Fifty eligible adults randomized in 1:1 ratio (HSRV: Placebo) followed by 50 eligible infants randomized in 1:1 ratio (HSRV: Comparator (RotaTeq®, pentavalent human-bovine (WC3) reassortant liveattenuated, rotavirus vaccine)). Intervention: Adults received either a single dose of HSRV or placebo and followed for 14 days. Infants received three doses of either HSRV or comparator with a follow-up for 28 days after each dose. Main Outcome Measures: Solicited and unsolicited adverse events (AEs) along with any serious adverse events (SAEs) were part of the safety and reactogenicity assessment in adults and infants whereas serum anti-rotavirus IgA response rates were part of immunogenicity assessment in infants only. Postvaccination fecal shedding of vaccine-virus rotavirus strains was also determined in adults and infants. Results: In this study, HSRV, when compared with placebo, did not result in increase in solicited adverse events (solicited AEs) in adults. In infants, HSRV had a safety profile similar to comparator vis-à-vis solicited AEs. In infants, fecal shedding of vaccine-virus strains was not detected in HSRV recipients but was observed in two comparator recipients. Percentage of infants exhibiting threefold rise in serum antirotavirus IgA titers from baseline to 1-month post-dose 3 in HSRV group was 88% (22/25) and 84% (21/ 25) in comparator group. Conclusion: HSRV was found to be generally well-tolerated in both adults and infants and immunogenic in infants.

Aging and disease, 2011

Older age has long been associated with altered inflammation and hemostasis regulation. Emerging ... more Older age has long been associated with altered inflammation and hemostasis regulation. Emerging evidence suggests that age-related differences in inflammation and hemostasis abnormalities may play a role in the development of and long-term outcomes after critical illness. A better understanding of underlying mechanisms may provide new possibilities for therapeutic interventions. In this review, we will examine how age-related differences in inflammatory and coagulation responses are affected through the continuum of healthy state, before infection occurs, to severe sepsis and recovery.

International Journal of Research in Orthopaedics

Background: Intramedullary nailing of compound shaft humerus fractures has been an innovative and... more Background: Intramedullary nailing of compound shaft humerus fractures has been an innovative and surgically friendly technique to deal with extensive soft tissue injury that impedes open reduction and internal fixation. The purpose of this article is to highlight the minimally invasive technique of intramedullary humerus nailing to prevent the perioperative and postoperative complications encountered. A 1 year follow up of all the patients have shown functionally excellent results and good surgical outcome. Methods: We have conducted this prospective study from Jan 2020 to Jan 2022 at DR. D.Y. Patil medical college and hospital. Informed consent from each patient was taken explaining the methods of study and probable complications. By this 3-stitch technique we have treated 25 adult patients sustaining post traumatic compound humerus shaft fractures by Antegrade humerus nailing. We have included compound injury upto type 3A (Gustilo-Anderson classification). Results: Out of the 25...

Anaesthesia, 2021

SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...

Anaesthesia, 2021

SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...

Journal of clinical orthopaedics, 2023

Journal of clinical orthopaedics, 2023

Journal of Clinical Orthopaedics

Introduction: Burnout is a syndrome denoting the outcome of chronic work stress which has not bee... more Introduction: Burnout is a syndrome denoting the outcome of chronic work stress which has not been managed successfully. Burnout has only sometimes been at the forefront of studies in healthcare, where patient care and management have received more attention. This study focuses particularly on burnout of residents and healthcare workers during the COVID-19 pandemic that has changed the working environment. Material and Methods: Questionnaires in the form of surveys have been used to receive feedback regarding work experience within the bubble of isolation and high patient load unique to COVID-19 pandemic. A full and complete analysis of the research is provided after the definition, description, and measurement of burnout are given. Results: According to a review of the burnout literature, burnout affects medical students, residents, and practicing doctors, with prevalence rates ranging from 28% to 45% for each group. First-year residency during the COVID-19 pandemic, in particular,...

MGM Journal of Medical Sciences

The Lancet

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as ind... more Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45•6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84•5 (95% CI 84•1-84•9), which varied between HIC (88•5 [89•0-88•0]), MIC (81•8 [82•5-81•1]), and LIC (66•8 [64•9-68•7]) settings. In the third phase, 1217 (74•6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51•4%) were from HIC, 538 (44•2%) from MIC, and 54 (4•4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3•6% (95% CI 3•0-4•1; p<0•0001) increase in SVR. This was consistent in HIC (4•8% [4•1-5•5]; p<0•0001), MIC (2•8 [2•0-3•7]; p<0•0001), and LIC (3•8 [1•3-6•7%]; p<0•0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs.

Journal of Research and Practice on the Musculoskeletal System

British Journal of Surgery

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The a... more Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains...

International Journal of Research in Orthopaedics

Background: Radiographic imaging in orthopaedic surgical centers is becoming more common, posing ... more Background: Radiographic imaging in orthopaedic surgical centers is becoming more common, posing additional risks to the orthopaedic doctors, who become more exposed to ionising irradiation. As a result, orthopaedic surgeons must have a good understanding of radiation hazards. Despite these issues, many orthopaedic specialists do not get basic radiation safety training. A review of orthopaedic specialists' understanding, awareness, and routine radiation safety practices at an academic hospital in Navi Mumbai. Methods: After institutional ethical approval, a panel of experts created an online survey comprising multiple-choice questions, which was utilized to perform a descriptive research. The questionnaire contained several aspects, each of which assessed orthopaedic understanding, awareness, and practices. The research cohort comprised orthopaedic doctors working through our tertiary medical center and medical college. Results: According to our findings, only 82% of respondents...

International Journal of Research in Orthopaedics

Background: Incidence of ACL injuries and physical parameters like age, sex, height, weight and B... more Background: Incidence of ACL injuries and physical parameters like age, sex, height, weight and BMI has been studied intensely as a risk factor. Each of them poses as a different risk factor for occurrence of ACL injuries. But body-built index-somatotype considers relative proportions of fatness, muscle mass and skeletal architecture in terms of endomorphy, mesomorphy and ectomorphy in a single individual which neutralises variables like age, sex, BMI. Methods: 100 patients were included in the study, excluding those with multiligament injuries, associated fractures around knee, mucoid degeneration of ACL and road traffic accident cases. Parameters such as skin fold thickness, circumference and epicondylar, condylar width was taken into consideration. Body built index was calculated in terms of endomorphy, mesomorphy and ectomorphy using the heath-carter anthropometric somatotype manual. Results: We found that amongst all those have ACL injury, endomorphy was higher grade (5.49), fo...

International Journal of Orthopaedics Sciences, 2020

Femoral neck fractures are rare in children until and unless there is a high energy trauma. This ... more Femoral neck fractures are rare in children until and unless there is a high energy trauma. This paper describes an unusual case of neck of femur fracture in a girl with very low vitamin Dof <4.20 ng/ml successfully managed by open reduction and internal fixation with dynamic hip screw. No clinical or radiological signs of avascular necrosis were observed in four months of follow-up.

Surgical Update: International Journal of Surgery and Orthopedics, 2017

Introduction: Fracture of distal femur and proximal tibial are often difficult to treat and assoc... more Introduction: Fracture of distal femur and proximal tibial are often difficult to treat and associated with many complications. We aimed to assess the clinical and radiological union time and functional outcome in fractures of distal femur and proximal tibia managed by metaphyseal locking plates and to study the complications associated with it. Methodology: This prospective study was conducted from

Journal of Pain and Symptom Management, 2020

Respirology, 2019

radiography findings. These cases eventually had been proven as lung tuberculosis from molecular ... more radiography findings. These cases eventually had been proven as lung tuberculosis from molecular sputum examination. Methods: We evaluated 2 patients were presumptive of lung cancer from radiography findings but had been proven as lung tuberculosis Results: First patient, male, 36 years old referred with, chronic productive cough, breathlessness, right chest pain and weight loss in

Human Vaccines & Immunotherapeutics, 2019

Objectives: To assess the safety and reactogenicity of single oral dose of heat-stable rotavirus ... more Objectives: To assess the safety and reactogenicity of single oral dose of heat-stable rotavirus vaccine (HSRV) in healthy adults aged 18-45 years followed by assessment of safety, reactogenicity, and immunogenicity of three doses of HSRV in healthy infants aged 6-8 weeks at enrollment. Trial Design: Single-center randomized controlled, sequential, blinded (adults) and open-label (infants). Setting: Single site at International Center for Diarrheal Disease Research, Bangladesh (icddr,b). Participants: Fifty eligible adults randomized in 1:1 ratio (HSRV: Placebo) followed by 50 eligible infants randomized in 1:1 ratio (HSRV: Comparator (RotaTeq®, pentavalent human-bovine (WC3) reassortant liveattenuated, rotavirus vaccine)). Intervention: Adults received either a single dose of HSRV or placebo and followed for 14 days. Infants received three doses of either HSRV or comparator with a follow-up for 28 days after each dose. Main Outcome Measures: Solicited and unsolicited adverse events (AEs) along with any serious adverse events (SAEs) were part of the safety and reactogenicity assessment in adults and infants whereas serum anti-rotavirus IgA response rates were part of immunogenicity assessment in infants only. Postvaccination fecal shedding of vaccine-virus rotavirus strains was also determined in adults and infants. Results: In this study, HSRV, when compared with placebo, did not result in increase in solicited adverse events (solicited AEs) in adults. In infants, HSRV had a safety profile similar to comparator vis-à-vis solicited AEs. In infants, fecal shedding of vaccine-virus strains was not detected in HSRV recipients but was observed in two comparator recipients. Percentage of infants exhibiting threefold rise in serum antirotavirus IgA titers from baseline to 1-month post-dose 3 in HSRV group was 88% (22/25) and 84% (21/ 25) in comparator group. Conclusion: HSRV was found to be generally well-tolerated in both adults and infants and immunogenic in infants.

Aging and disease, 2011

Older age has long been associated with altered inflammation and hemostasis regulation. Emerging ... more Older age has long been associated with altered inflammation and hemostasis regulation. Emerging evidence suggests that age-related differences in inflammation and hemostasis abnormalities may play a role in the development of and long-term outcomes after critical illness. A better understanding of underlying mechanisms may provide new possibilities for therapeutic interventions. In this review, we will examine how age-related differences in inflammatory and coagulation responses are affected through the continuum of healthy state, before infection occurs, to severe sepsis and recovery.

International Journal of Research in Orthopaedics

Background: Intramedullary nailing of compound shaft humerus fractures has been an innovative and... more Background: Intramedullary nailing of compound shaft humerus fractures has been an innovative and surgically friendly technique to deal with extensive soft tissue injury that impedes open reduction and internal fixation. The purpose of this article is to highlight the minimally invasive technique of intramedullary humerus nailing to prevent the perioperative and postoperative complications encountered. A 1 year follow up of all the patients have shown functionally excellent results and good surgical outcome. Methods: We have conducted this prospective study from Jan 2020 to Jan 2022 at DR. D.Y. Patil medical college and hospital. Informed consent from each patient was taken explaining the methods of study and probable complications. By this 3-stitch technique we have treated 25 adult patients sustaining post traumatic compound humerus shaft fractures by Antegrade humerus nailing. We have included compound injury upto type 3A (Gustilo-Anderson classification). Results: Out of the 25...

Anaesthesia, 2021

SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...

Anaesthesia, 2021

SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...