7 results on '"Hughes, Luke"'
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2. IMPACT-Global Hip Fracture Audit: Nosocomial infection, risk prediction and prognostication, minimum reporting standards and global collaborative audit. Lessons from an international multicentre study of 7,090 patients conducted in 14 nations during the COVID-19 pandemic
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Hall, Andrew J., Clement, Nicholas D., Ojeda-Thies, Cristina, MacLullich, Alasdair MJ., Toro, Giuseppe, Johansen, Antony, White, Tim O., Duckworth, Andrew D., Abdul-Jabar, Hani, Abu-Rajab, Rashid, Abugarja, Ahmed, Adam, Karen, Aguado Hernández, Héctor J., Améstica Lazcano, Gedeón, Anderson, Sarah, Ansar, Mahmood, Antrobus, Jonathan, Aragón Achig, Esteban Javier, Archunan, Maheswaran, Arrieta Salinas, Mirentxu, Ashford-Wilson, Sarah, Assens Gibert, Cristina, Athanasopoulou, Katerina, Awadelkarim, Mohamed, Baird, Stuart, Bajada, Stefan, Balakrishnan, Shobana, Balasubramanian, Sathishkumar, Ballantyne, James A., Bárcena Goitiandia, Leopoldo, Barkham, Benjamin, Barmpagianni, Christina, Barres-Carsi, Mariano, Barrett, Sarah, Baskaran, Dinnish, Bell, Jean, Bell, Katrina, Bell, Stuart, Bellelli, Giuseppe, Benchimol, Javier Alberto, Boietti, Bruno Rafael, Boswell, Sally, Braile, Adriano, Brennan, Caitlin, Brent, Louise, Brooke, Ben, Bruno, Gaetano, Burahee, Abdus, Burns, Shirley, Calabrò, Giampiero, Campbell, Lucy, Carabelli, Guido Sebastian, Carnegie, Carol, Carretero Cristobal, Guillermo, Caruana, Ethan, Cassinello Ogea, M. a Concepción, Castellanos Robles, Juan, Castillon, Pablo, Chakrabarti, Anil, Cecere, Antonio Benedetto, Chen, Ping, Clarke, Jon V., Collins, Grace, Corrales Cardenal, Jorge E., Corsi, Maurizio, Cózar Adelantado, Gara María, Craxford, Simon, Crooks, Melissa, Cuarental-García, Javier, Cuthbert, Rory, Dall, Graham, Daskalakis, Ioannis, De Cicco, Annalisa, Diana, de la Fuente de Dios, Demaria, Pablo, Dereix, John, Díaz Jiménez, Julian, Dinamarca Montecinos, José Luis, Do Le, Ha Phuong, Donoso Coppa, Juan Pablo, Drosos, Georgios, Duffy, Andrew, East, Jamie, Eastwood, Deborah, Elbahari, Hassan, Elias de Molins Peña, Carmen, Elmamoun, Mamoun, Emmerson, Ben, Escobar Sánchez, Daniel, Faimali, Martina, Farré-Mercadé, Maria Victòria, Farrow, Luke, Fayez, Almari, Fell, Adam, Fenner, Christopher, Ferguson, David, Finlayson, Louise, Flores Gómez, Aldo, Freeman, Nicholas, French, Jonathan, Gabardo Calvo, Santiago, Gagliardo, Nicola, Garcia Albiñana, Joan, García Cruz, Guillermo, García de Cortázar Antolín, Unai, García Virto, Virginia, Gealy, Sophie, Gil Caballero, Sandra Marcela, Gill, Moneet, González González, María Soledad, Gopireddy, Rajesh, Guntley, Diane, Gurung, Binay, Guzmán Rosales, Guadalupe, Haddad, Nedaa, Hafeez, Mahum, Haller, Petra, Halligan, Emer, Hardie, John, Hawker, Imogen, Helal, Amr, Herrera Cruz, Mariana, Herreros Ruiz-Valdepeñas, Ruben, Horton, James, Howells, Sean, Howieson, Alan, Hughes, Luke, Hünicken Torrez, Flavia Lorena, Hurtado Ortega, Ana, Huxley, Peter, Hamid, Hytham K. S., Ilahi, Nida, Iliadis, Alexis, Inman, Dominic, Jadhao, Piyush, Jandoo, Rajan, Jawad, Lucy, Jayatilaka, Malwattage Lara Tania, Jenkins, Paul J., Jeyapalan, Rathan, Johnson, David, Johnston, Andrew, Joseph, Sarah, Kapoor, Siddhant, Karagiannidis, Georgios, Karanam, Krishna Saga, Kattakayam, Freddy, Konarski, Alastair, Kontakis, Georgios, Labrador Hernández, Gregorio, Lancaster, Victoria, Landi, Giovanni, Le, Brian, Liew, Ignatius, Logishetty, Kartik, Lopez Marquez, Andrew Carlomaria Daniel, Lopez, Judit, Lum, Joann, Macpherson, Gavin J., Madan, Suvira, Mahroof, Sabreena, Malik-Tabassum, Khalid, Mallina, Ravi, Maqsood, Afnan, Marson, Ben, Martin Legorburo, M José, Martin-Perez, Encarna, Martínez Jiménez, Tania, Martinez Martin, Javier, Mayne, Alistair, Mayor, Amy, McAlinden, Gavan, McLean, Lucille, McDonald, Lorna, McIntyre, Joshua, McKay, Pamela, McKean, Greg, McShane, Heather, Medici, Antonio, Meeke, Chelsea, Meldrum, Evonne, Mendez, Mijail, Mercer, Scott, Merino Perez, Josu, Mesa-Lampré, María-Pilar, Mighton, Shuna, Milne, Kirsty, Mohamed Yaseen, Muhammed, Moppett, Iain, Mora, Jesus, Morales-Zumel, Sira, Moreno Fenoll, Irene Blanca, Mousa, Adham, Murray, Alastair W., Murray, Elspeth V., Nair, Radhika, Neary, Fiona, Negri, Giacomo, Negus, Oliver, Newham-Harvey, Fiona, Ng, Nigel, Nightingale, Jess, Noor Mohamed Anver, Sumiya, Nunag, Perrico, O'Hare, Matthew, Ollivere, Ben, Ortés Gómez, Raquel, Owens, AnneMarie, Page, Siobhan, Palloni, Valentina, Panagiotopoulos, Andreas, Panagiotopoulos, Elias, Panesar, Paul, Papadopoulos, Antonios, Spyridon, Papagiannis, Pareja Sierra, Teresa, Park, Chang, Parwaiz, Hammad, Paterson-Byrne, Paul, Patton, Sam, Pearce, Jack, Porter, Marina, Pellegrino, Achille, Pèrez Cuellar, Arturo, Pezzella, Raffaele, Phadnis, Ashish, Pinder, Charlotte, Piper, Danielle, Powell-Bowns, Matilda, Prieto Martín, Rocío, Probert, Annabel, Ramesh, Ashwanth, Ramírez de Arellano, Manuel Vicente Mejía, Renton, Duncan, Rickman, Stephen, Robertson, Alastair, Roche Albero, Adrian, Rodrigo Verguizas, José Alberto, Rodríguez Couso, Myriam, Rooney, Joanna, Sáez-López, Pilar, Saldaña-Díaz, Andres, Santulli, Adriano, Sanz Pérez, Marta Isabel, Sarraf, Khaled M., Scarsbrook, Christine, Scott, Chloe E. H., Scott, Jennifer, Shah, Sachi, Sharaf, Sharief, Sharma, Sidharth, Shirley, Denise, Siano, Antonio, Simpson, James, Singh, Abhinav, Singh, Amit, Sinnett, Tim, Sisodia, Gurudatt, Smith, Philomena, Sophena Bert, Eugenia, Steel, Michael, Stewart, Avril, Stewart, Claire, Sugand, Kapil, Sullivan, Niall, Sweeting, Lauren, Symes, Michael, Tan, Dylan Jun Hao, Tancredi, Francesco, Tatani, Irini, Thomas, Philip, Thomson, Fraser, Toner, Niamh S., Tong, Anna, Toro, Antonio, Tosounidis, Theodoros, Tottas, Stylianos, Trinidad Leo, Andrea, Tucker, Damien, Vemulapalli, Krishna, Ventura Garces, Diego, Vernon, Olivia Katherine, Viveros Garcia, Juan Carlos, Ward, Alex, Ward, Kirsty, Watson, Kate, Weerasuriya, Thisara, Wickramanayake, Udara, Wilkinson, Hannah, Windley, Joseph, Wood, Janet, Wynell-Mayow, William, Zatti, Giovanni, Zeiton, Moez, Zurrón Lobato, Miriam, Hall, A, Clement, N, Ojeda-Thies, C, Maclullich, A, Toro, G, Johansen, A, White, T, Duckworth, A, Abdul-Jabar, H, Abu-Rajab, R, Abugarja, A, Adam, K, Aguado Hernández, H, Améstica Lazcano, G, Anderson, S, Ansar, M, Antrobus, J, Aragón Achig, E, Archunan, M, Arrieta Salinas, M, Ashford-Wilson, S, Assens Gibert, C, Athanasopoulou, K, Awadelkarim, M, Baird, S, Bajada, S, Balakrishnan, S, Balasubramanian, S, Ballantyne, J, Bárcena Goitiandia, L, Barkham, B, Barmpagianni, C, Barres-Carsi, M, Barrett, S, Baskaran, D, Bell, J, Bell, K, Bell, S, Bellelli, G, Benchimol, J, Boietti, B, Boswell, S, Braile, A, Brennan, C, Brent, L, Brooke, B, Bruno, G, Burahee, A, Burns, S, Calabrò, G, Campbell, L, Carabelli, G, Carnegie, C, Carretero Cristobal, G, Caruana, E, Cassinello Ogea, M, Castellanos Robles, J, Castillon, P, Chakrabarti, A, Cecere, A, Chen, P, Clarke, J, Collins, G, Corrales Cardenal, J, Corsi, M, Cózar Adelantado, G, Craxford, S, Crooks, M, Cuarental-García, J, Cuthbert, R, Dall, G, Daskalakis, I, De Cicco, A, Diana, D, Demaria, P, Dereix, J, Díaz Jiménez, J, Dinamarca Montecinos, J, Do Le, H, Donoso Coppa, J, Drosos, G, Duffy, A, East, J, Eastwood, D, Elbahari, H, Elias de Molins Peña, C, Elmamoun, M, Emmerson, B, Escobar Sánchez, D, Faimali, M, Farré-Mercadé, M, Farrow, L, Fayez, A, Fell, A, Fenner, C, Ferguson, D, Finlayson, L, Flores Gómez, A, Freeman, N, French, J, Gabardo Calvo, S, Gagliardo, N, Garcia Albiñana, J, García Cruz, G, García de Cortázar Antolín, U, García Virto, V, Gealy, S, Gil Caballero, S, Gill, M, González González, M, Gopireddy, R, Guntley, D, Gurung, B, Guzmán Rosales, G, Haddad, N, Hafeez, M, Haller, P, Halligan, E, Hardie, J, Hawker, I, Helal, A, Herrera Cruz, M, Herreros Ruiz-Valdepeñas, R, Horton, J, Howells, S, Howieson, A, Hughes, L, Hünicken Torrez, F, Hurtado Ortega, A, Huxley, P, Hamid, H, Ilahi, N, Iliadis, A, Inman, D, Jadhao, P, Jandoo, R, Jawad, L, Jayatilaka, M, Jenkins, P, Jeyapalan, R, Johnson, D, Johnston, A, Joseph, S, Kapoor, S, Karagiannidis, G, Karanam, K, Kattakayam, F, Konarski, A, Kontakis, G, Labrador Hernández, G, Lancaster, V, Landi, G, Le, B, Liew, I, Logishetty, K, Lopez Marquez, A, Lopez, J, Lum, J, Macpherson, G, Madan, S, Mahroof, S, Malik-Tabassum, K, Mallina, R, Maqsood, A, Marson, B, Martin Legorburo, M, Martin-Perez, E, Martínez Jiménez, T, Martinez Martin, J, Mayne, A, Mayor, A, Mcalinden, G, Mclean, L, Mcdonald, L, Mcintyre, J, Mckay, P, Mckean, G, Mcshane, H, Medici, A, Meeke, C, Meldrum, E, Mendez, M, Mercer, S, Merino Perez, J, Mesa-Lampré, M, Mighton, S, Milne, K, Mohamed Yaseen, M, Moppett, I, Mora, J, Morales-Zumel, S, Moreno Fenoll, I, Mousa, A, Murray, A, Murray, E, Nair, R, Neary, F, Negri, G, Negus, O, Newham-Harvey, F, Ng, N, Nightingale, J, Noor Mohamed Anver, S, Nunag, P, O'Hare, M, Ollivere, B, Ortés Gómez, R, Owens, A, Page, S, Palloni, V, Panagiotopoulos, A, Panagiotopoulos, E, Panesar, P, Papadopoulos, A, Spyridon, P, Pareja Sierra, T, Park, C, Parwaiz, H, Paterson-Byrne, P, Patton, S, Pearce, J, Porter, M, Pellegrino, A, Pèrez Cuellar, A, Pezzella, R, Phadnis, A, Pinder, C, Piper, D, Powell-Bowns, M, Prieto Martín, R, Probert, A, Ramesh, A, Ramírez de Arellano, M, Renton, D, Rickman, S, Robertson, A, Roche Albero, A, Rodrigo Verguizas, J, Rodríguez Couso, M, Rooney, J, Sáez-López, P, Saldaña-Díaz, A, Santulli, A, Sanz Pérez, M, Sarraf, K, Scarsbrook, C, Scott, C, Scott, J, Shah, S, Sharaf, S, Sharma, S, Shirley, D, Siano, A, Simpson, J, Singh, A, Sinnett, T, Sisodia, G, Smith, P, Sophena Bert, E, Steel, M, Stewart, A, Stewart, C, Sugand, K, Sullivan, N, Sweeting, L, Symes, M, Tan, D, Tancredi, F, Tatani, I, Thomas, P, Thomson, F, Toner, N, Tong, A, Toro, A, Tosounidis, T, Tottas, S, Trinidad Leo, A, Tucker, D, Vemulapalli, K, Ventura Garces, D, Vernon, O, Viveros Garcia, J, Ward, A, Ward, K, Watson, K, Weerasuriya, T, Wickramanayake, U, Wilkinson, H, Windley, J, Wood, J, Wynell-Mayow, W, Zatti, G, Zeiton, M, Zurrón Lobato, M, Hall, Andrew J., Clement, Nicholas D., Ojeda-Thies, Cristina, Maclullich, Alasdair MJ., Toro, Giuseppe, Johansen, Antony, White, Tim O., Duckworth, Andrew D., Abdul-Jabar, Hani, Abu-Rajab, Rashid, Abugarja, Ahmed, Adam, Karen, Aguado Hernández, Héctor J., Améstica Lazcano, Gedeón, Anderson, Sarah, Ansar, Mahmood, Antrobus, Jonathan, Aragón Achig, Esteban Javier, Archunan, Maheswaran, Arrieta Salinas, Mirentxu, Ashford-Wilson, Sarah, Assens Gibert, Cristina, Athanasopoulou, Katerina, Awadelkarim, Mohamed, Baird, Stuart, Bajada, Stefan, Balakrishnan, Shobana, Balasubramanian, Sathishkumar, Ballantyne, James A., Bárcena Goitiandia, Leopoldo, Barkham, Benjamin, Barmpagianni, Christina, Barres-Carsi, Mariano, Barrett, Sarah, Baskaran, Dinnish, Bell, Jean, Bell, Katrina, Bell, Stuart, Bellelli, Giuseppe, Benchimol, Javier Alberto, Boietti, Bruno Rafael, Boswell, Sally, Braile, Adriano, Brennan, Caitlin, Brent, Louise, Brooke, Ben, Bruno, Gaetano, Burahee, Abdu, Burns, Shirley, Calabrò, Giampiero, Campbell, Lucy, Carabelli, Guido Sebastian, Carnegie, Carol, Carretero Cristobal, Guillermo, Caruana, Ethan, Cassinello Ogea, M. a Concepción, Castellanos Robles, Juan, Castillon, Pablo, Chakrabarti, Anil, Cecere, Antonio Benedetto, Chen, Ping, Clarke, Jon V., Collins, Grace, Corrales Cardenal, Jorge E., Corsi, Maurizio, Cózar Adelantado, Gara María, Craxford, Simon, Crooks, Melissa, Cuarental-García, Javier, Cuthbert, Rory, Dall, Graham, Daskalakis, Ioanni, De Cicco, Annalisa, Diana, de la Fuente de Dio, Demaria, Pablo, Dereix, John, Díaz Jiménez, Julian, Dinamarca Montecinos, José Lui, Do Le, Ha Phuong, Donoso Coppa, Juan Pablo, Drosos, Georgio, Duffy, Andrew, East, Jamie, Eastwood, Deborah, Elbahari, Hassan, Elias de Molins Peña, Carmen, Elmamoun, Mamoun, Emmerson, Ben, Escobar Sánchez, Daniel, Faimali, Martina, Farré-Mercadé, Maria Victòria, Farrow, Luke, Fayez, Almari, Fell, Adam, Fenner, Christopher, Ferguson, David, Finlayson, Louise, Flores Gómez, Aldo, Freeman, Nichola, French, Jonathan, Gabardo Calvo, Santiago, Gagliardo, Nicola, Garcia Albiñana, Joan, García Cruz, Guillermo, García de Cortázar Antolín, Unai, García Virto, Virginia, Gealy, Sophie, Gil Caballero, Sandra Marcela, Gill, Moneet, González González, María Soledad, Gopireddy, Rajesh, Guntley, Diane, Gurung, Binay, Guzmán Rosales, Guadalupe, Haddad, Nedaa, Hafeez, Mahum, Haller, Petra, Halligan, Emer, Hardie, John, Hawker, Imogen, Helal, Amr, Herrera Cruz, Mariana, Herreros Ruiz-Valdepeñas, Ruben, Horton, Jame, Howells, Sean, Howieson, Alan, Hughes, Luke, Hünicken Torrez, Flavia Lorena, Hurtado Ortega, Ana, Huxley, Peter, Hamid, Hytham K. S., Ilahi, Nida, Iliadis, Alexi, Inman, Dominic, Jadhao, Piyush, Jandoo, Rajan, Jawad, Lucy, Jayatilaka, Malwattage Lara Tania, Jenkins, Paul J., Jeyapalan, Rathan, Johnson, David, Johnston, Andrew, Joseph, Sarah, Kapoor, Siddhant, Karagiannidis, Georgio, Karanam, Krishna Saga, Kattakayam, Freddy, Konarski, Alastair, Kontakis, Georgio, Labrador Hernández, Gregorio, Lancaster, Victoria, Landi, Giovanni, Le, Brian, Liew, Ignatiu, Logishetty, Kartik, Lopez Marquez, Andrew Carlomaria Daniel, Lopez, Judit, Lum, Joann, Macpherson, Gavin J., Madan, Suvira, Mahroof, Sabreena, Malik-Tabassum, Khalid, Mallina, Ravi, Maqsood, Afnan, Marson, Ben, Martin Legorburo, M José, Martin-Perez, Encarna, Martínez Jiménez, Tania, Martinez Martin, Javier, Mayne, Alistair, Mayor, Amy, Mcalinden, Gavan, Mclean, Lucille, Mcdonald, Lorna, Mcintyre, Joshua, Mckay, Pamela, Mckean, Greg, Mcshane, Heather, Medici, Antonio, Meeke, Chelsea, Meldrum, Evonne, Mendez, Mijail, Mercer, Scott, Merino Perez, Josu, Mesa-Lampré, María-Pilar, Mighton, Shuna, Milne, Kirsty, Mohamed Yaseen, Muhammed, Moppett, Iain, Mora, Jesu, Morales-Zumel, Sira, Moreno Fenoll, Irene Blanca, Mousa, Adham, Murray, Alastair W., Murray, Elspeth V., Nair, Radhika, Neary, Fiona, Negri, Giacomo, Negus, Oliver, Newham-Harvey, Fiona, Ng, Nigel, Nightingale, Je, Noor Mohamed Anver, Sumiya, Nunag, Perrico, O'Hare, Matthew, Ollivere, Ben, Ortés Gómez, Raquel, Owens, Annemarie, Page, Siobhan, Palloni, Valentina, Panagiotopoulos, Andrea, Panagiotopoulos, Elia, Panesar, Paul, Papadopoulos, Antonio, Spyridon, Papagianni, Pareja Sierra, Teresa, Park, Chang, Parwaiz, Hammad, Paterson-Byrne, Paul, Patton, Sam, Pearce, Jack, Porter, Marina, Pellegrino, Achille, Pèrez Cuellar, Arturo, Pezzella, Raffaele, Phadnis, Ashish, Pinder, Charlotte, Piper, Danielle, Powell-Bowns, Matilda, Prieto Martín, Rocío, Probert, Annabel, Ramesh, Ashwanth, Ramírez de Arellano, Manuel Vicente Mejía, Renton, Duncan, Rickman, Stephen, Robertson, Alastair, Roche Albero, Adrian, Rodrigo Verguizas, José Alberto, Rodríguez Couso, Myriam, Rooney, Joanna, Sáez-López, Pilar, Saldaña-Díaz, Andre, Santulli, Adriano, Sanz Pérez, Marta Isabel, Sarraf, Khaled M., Scarsbrook, Christine, Scott, Chloe E. H., Scott, Jennifer, Shah, Sachi, Sharaf, Sharief, Sharma, Sidharth, Shirley, Denise, Siano, Antonio, Simpson, Jame, Singh, Abhinav, Singh, Amit, Sinnett, Tim, Sisodia, Gurudatt, Smith, Philomena, Sophena Bert, Eugenia, Steel, Michael, Stewart, Avril, Stewart, Claire, Sugand, Kapil, Sullivan, Niall, Sweeting, Lauren, Symes, Michael, Tan, Dylan Jun Hao, Tancredi, Francesco, Tatani, Irini, Thomas, Philip, Thomson, Fraser, Toner, Niamh S., Tong, Anna, Toro, Antonio, Tosounidis, Theodoro, Tottas, Styliano, Trinidad Leo, Andrea, Tucker, Damien, Vemulapalli, Krishna, Ventura Garces, Diego, Vernon, Olivia Katherine, Viveros Garcia, Juan Carlo, Ward, Alex, Ward, Kirsty, Watson, Kate, Weerasuriya, Thisara, Wickramanayake, Udara, Wilkinson, Hannah, Windley, Joseph, Wood, Janet, Wynell-Mayow, William, Zatti, Giovanni, Zeiton, Moez, and Zurrón Lobato, Miriam
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Risk ,Frailty ,Communicable disease ,Prognosi ,COVID-19 ,Audit ,Orthopaedic ,Trauma ,Hip fracture ,Reporting standard ,Meta-audit ,Nosocomial ,Infection ,Geriatric ,Outcome - Abstract
Aims: This international study aimed to assess: 1) the prevalence of preoperative and postoperative COVID-19 among patients with hip fracture, 2) the effect on 30-day mortality, and 3) clinical factors associated with the infection and with mortality in COVID-19-positive patients. Methods: A multicentre collaboration among 112 centres in 14 countries collected data on all patients presenting with a hip fracture between 1st March-31st May 2020. Demographics, residence, place of injury, presentation blood tests, Nottingham Hip Fracture Score, time to surgery, management, ASA grade, length of stay, COVID-19 and 30-day mortality status were recorded. Results: A total of 7090 patients were included, with a mean age of 82.2 (range 50–104) years and 4959 (69.9%) being female. Of 651 (9.2%) patients diagnosed with COVID-19, 225 (34.6%) were positive at presentation and 426 (65.4%) were positive postoperatively. Positive COVID-19 status was independently associated with male sex (odds ratio (OR) 1.38, p = 0.001), residential care (OR 2.15, p < 0.001), inpatient fall (OR 2.23, p = 0.003), cancer (OR 0.63, p = 0.009), ASA grades 4 (OR 1.59, p = 0.008) or 5 (OR 8.28, p < 0.001), and longer admission (OR 1.06 for each increasing day, p < 0.001). Patients with COVID-19 at any time had a significantly lower chance of 30-day survival versus those without COVID-19 (72.7% versus 92.6%, p < 0.001). COVID-19 was independently associated with an increased 30-day mortality risk (hazard ratio (HR) 2.83, p < 0.001). Increasing age (HR 1.03, p = 0.028), male sex (HR 2.35, p < 0.001), renal disease (HR 1.53, p = 0.017), and pulmonary disease (HR 1.45, p = 0.039) were independently associated with a higher 30-day mortality risk in patients with COVID-19 when adjusting for confounders. Conclusion: The prevalence of COVID-19 in hip fracture patients during the first wave of the pandemic was 9%, and was independently associated with a three-fold increased 30-day mortality risk. Among COVID-19-positive patients, those who were older, male, with renal or pulmonary disease had a significantly higher 30-day mortality risk.
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- 2022
3. Surgical fixation with K-wires versus casting in adults with fracture of distal radius: DRAFFT2 multicentre randomised clinical trial
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Costa, Matthew L, Achten, Juul, Ooms, Alexander, Png, May Ee, Cook, Jonathan A, Lamb, Sarah E, Hedley, Helen, Dias, Joseph, Dritsaki, Melina, Dakin, Helen, Jones, Jonathan, Mckee, Andrew, Smith, Kevin, Hamadto, Mohamed, Gwilym, Steve, Chesser, Tim, Candal-Couto, Jaime, Hing, Caroline, Giddin, David, Johnston, Phil, Ullah, Aamer, Williams, John, Eardley, Will, Srinivasan, Makaram, Sampalli, Sridharrao, Farrar, Mark, Roberts, Chris, Mohanty, Khitish, MacLeod, Iain, Sarda, Praveen, Elseehy, Amr, Rossiter, Nigel, Warwick, David, Peach, Chris, MacKay, David, Benson, Richard, Watts, Adam, Young, Jonathan, Shah, Feisal, Lipscombe, Stephen, Ng, Aaron, Charalambous, Bambos, Sheriden, Barnaby, Theivendran, Kanthan, Sanjay, Pulimamidi, Nanda, Rajesh, Bateman, Antony, Butler, Michael, Keast-Butler, Oliver, McAndrew, Andrew, Chevannes, Wystan, Kankanalu, Pradeep, Wijendra, Asanka, Fontalis, Andreas, Afifi, Hytham, Killen, Marie-Clare, Higgin, Ryan, Wignadasan, Warran, Wong, Ken, Gibson, Catherine, Beale, Harry, Jennings, Bob, Kennedy, James, Williamson, Mark, Rasidovic, Damir, Jenner, Lydia, Tadros, John Baha, Milner, Steve, Duncan, James, Kerr, Sally, Nordin, Louise, Weston, Matt, Payton, Olivia, Oni, Tofi, Zhao, Craig, Gill, Sukhdeep, Iqbal, Mohammad, Aneiba, Khaled, Pillai, Dilip, Hughes, Luke, Crosby, Jonathan, Whitehouse, Mike, Corbett, Thomas, Iqbal, Arshad, Buchan, Steph, Beddard, Laura, Vardhan, Venkat, Beamish, Becky, Jones, Matt, Holley, Jonathan, Morrell, Rebecca, Lerner, Robin, and Draper, Kylea
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Adult ,Male ,Wrist Joint ,Adolescent ,Research ,General Medicine ,Middle Aged ,United Kingdom ,Casts, Surgical ,Young Adult ,Treatment Outcome ,Fracture Fixation ,Humans ,Female ,Radius Fractures ,Bone Wires - Abstract
Objective To assess wrist function, quality of life, and complications in adult patients with a dorsally displaced fracture of the distal radius, treated with either a moulded cast or surgical fixation with K-wires. Design Multicentre randomised clinical superiority trial, Setting 36 hospitals in the UK National Health Service (NHS). Participants 500 adults aged 16 or over with a dorsally displaced fracture of the distal radius, randomised after manipulation of their fracture (255 to moulded cast; 245 to surgical fixation). Interventions Manipulation and moulded cast was compared with manipulation and surgical fixation with K-wires plus cast. Details of the application of the cast and the insertion of the K-wires were at the discretion of the treating surgeon, according to their normal clinical practice. Main outcome measures The primary outcome measure was the Patient Rated Wrist Evaluation (PRWE) score at 12 months (five questions about pain and 10 about function and disability; overall score out of 100 (best score=0 and worst score=100)). Secondary outcomes were PRWE score at three and six months, quality of life, and complications, including the need for surgery due to loss of fracture position in the first six weeks. Results The mean age of participants was 60 years and 417 (83%) were women; 395 (79%) completed follow-up. No statistically significant difference in the PRWE score was seen at 12 months (cast group (n=200), mean 21.2 (SD 23.1); K-wire group (n=195), mean 20.7 (22.3); adjusted mean difference −0.34 (95% confidence interval −4.33 to 3.66), P=0.87). No difference was seen at earlier time points. In the cast group, 33 (13%) of participants needed surgical fixation for loss of fracture position in the first six weeks compared with one revision surgery in the K-wire group (odds ratio 0.02, 95% confidence interval 0.001 to 0.10). Conclusions Among patients with a dorsally displaced distal radius fracture that needed manipulation, surgical fixation with K-wires did not improve patients’ wrist function at 12 months compared with a cast. Trial registration ISRCTN registry ISRCTN11980540 .
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- 2022
4. The Evolution, Projection & Ambivalence of the Bosniak Classification
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Hughes, Luke
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Radiation safety ,Staging ,Observer performance ,Cysts ,Urinary Tract / Bladder ,CT - Abstract
Learning objectives Background Findings and procedure details Conclusion Personal information and conflict of interest References, Learning objectives: Describe the purpose for the development of the Bosniak Classification. Describe the individual classes of the Bosniak Classification, their distinguishing radiological features, associated rate of malignancy, and advised management course. Describe...
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- 2022
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5. Managing periprosthetic fractures – a review of the hub and spoke model
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Mudiganty Srikanth, Hughes Luke, Choudry Qaisar, and Bokhari Awais
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Orthopedic surgery ,Spoke ,Hub ,Original Article ,Periprosthetic fractures ,Orthopedics and Sports Medicine ,Surgery ,Lower Limb ,Unified classification system ,RD701-811 - Abstract
Introduction: Periprosthetic fractures are associated with significant morbidity and mortality. The “hub and spoke model” consists of a central organisation (the hub) and a series of secondary units (the spokes). This study reviews the presentation, management, and outcomes of periprosthetic fractures at a large general district hospital, the Royal Blackburn Hospital. Methods: A retrospective data analysis for patients presenting with periprosthetic fractures from a single general district hospital between January 2011 and December 2020. Details recorded were patient demographics, primary arthroplasty procedure, fracture management, ASA grade, morbidity and mortality, and Unified Classification System for Periprosthetic Fractures (UCSPF). Results: With 229 periprosthetic fractures, the number tripled in 2020 that admitted in 2011. The mean age was 78.6 years (range 33–100), 151 were females. Seventy-five percent of the fractures were managed locally, while 25% a referral to the higher specialist centre was sort. Of the 57 referrals, 50 were transferred to the hub, 5 were operated on locally, and 2 were managed non-operatively. Higher-level care transfer resulted in a delayed definitive treatment (4.8 versus 12 days, p = 0.001). About 94.4% of patients treated locally had a favourable outcome versus 92% of patients treated at the hub hospital. Cumulative mortality rates for the two sites were comparable. Discussion: Most of the patients presenting to the local spoke hospital with periprosthetic fractures were managed in house. For this practice to be preserved, there is a need for future planning, such as maintaining an appropriate skill mix at spoke units. Discussion between specialists at the hub and spoke hospitals reduced patient transfer by 14%.
- Published
- 2022
6. Blood Flow Restriction Training in Rehabilitation Following\ud Anterior Cruciate Ligament Reconstructive Surgery: A Review
- Author
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Hughes, Luke, Rosenblatt, Benjamin, Paton, Bruce, and Patterson, Stephen D.
- Abstract
Anterior cruciate ligament (ACL) rupture is a highly\ud prevalent orthopedic injury, resulting in substantial skeletal muscle atrophy because of changes in muscle protein balance and satellite cell abundance. Neural activation problems also contribute to strength loss, impacting upon a patients’ physical function and rehabilitative capacity.\ud \ud Heavy loads typically required for muscle hypertrophy and strength adaptations are contraindicated because of graft strain and concomitant cartilage, meniscal, and bone pathologies associated with ACL reconstruction. \ud \ud Strength of the quadriceps is a fundamental component for the ability to reduce shearing and torsional strains on the ACL with ground contact, and forms a critical component of ACL rehabilitation. Given the dangers of early postoperative heavy-loading, low-load blood flow restriction (BFR) training may provide an alternative rehabilitation tool for practitioners. Passive BFR can attenuate early muscle atrophy and strength loss, and may be more effective with the addition of novel, complementary therapies such as neuromuscular electrical stimulation.\ud \ud Upon ambulation, aerobic, and resistance exercise with BFR can stimulate muscle hypertrophy and strength adaptations and resolve activation problems. This may occur through increasing muscle protein synthesis and satellite cell proliferation, decreasing muscle protein breakdown and improving muscle activation by altered recruitment\ud patterns. Thus, BFR training may provide an effective rehabilitation tool that does not place heavy loads and force through the tibiofemoral joint. This may reduce the risk of damaging the graft, cartilage, meniscus, or other intra-articular structures, providing thorough screening before use is followed by correct, evidence-informed\ud application.
- Published
- 2018
7. Topics in equivariant cohomology
- Author
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Keating Hughes, Luke
- Published
- 2017
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