To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.

The aim of this cross-sectional study was to determine the prevalence of metabolic syndrome (MetS) and its components among 100 patients with progressive peripheral arterial disease (PAD) referred for diagnostic angiography in preparation for a revascularization procedure. The prevalence of MetS was more than 95%. Diabetes mellitus was the most prevalent component followed by hypertension and low high-density lipoprotein. Almost half the patients aggregated in the highest metabolic score category. A direct relationship was identified between the number of MetS components and serum uric acid (P = .001) and C-reactive protein (P = .826), whereas an inverse relationship was seen between the clustering of components and androgen levels in men (P < .001). For PAD, which could have a benign clinical course, early screening for MetS might identify those at greater risk of failing conservative therapy and progressing to a more aggressive atherosclerotic disease typically associated with high morbidity and mortality.

Civilian violence has increased in Kuwait. Vascular trauma to abdominal vessels is associated with high mortality. Autogenous saphenous vein forms an excellent conduit for revascularisation.

Objective: To determine whether or not elevated titers of antinuclear antibodies (ANA) and/or rheumatoid factor (RF) are associated with patients with advanced peripheral arterial disease (PAD). Subjects and Methods: A cross-sectional study was done between September 2005 and December 2006. Fifty-eight patients with clinical and angiographic evidence of PAD and 41 controls were studied. Controls had no documented history of peripheral, coronary or cerebral vascular disease. All subjects were screened for metabolic syndrome and C-reactive protein (CRP) as risk factors for peripheral vascular disease. Additionally, all were tested for anti-mitochondrial, anti-neutrophil cytoplasmic and anti-smooth muscle antibodies; those with positive results were excluded. ANA and RF were measured in sera from cases and controls. Results: One case and 3 controls had positive anti-smooth muscle antibodies and were therefore excluded from statistical analysis. Metabolic syndrome was significantly more prevalent in patients than controls (p < 0.05). Mean CRP level was 4.78 ± 7.70 and 2.65 ± 3.86 mg/dl in cases and controls, respectively (p = 0.021). ANA were detected at a titer of ≧1:40 in 6 (10.5%) of the advanced PAD patients but none of the controls; the difference was not statistically significant. RF was less prevalent in cases than controls (p < 0.05). Conclusion: RF and ANA do not appear to be associated with PAD in a Kuwaiti population.