Internal medicine journal
-
Internal medicine journal · May 2023
Observational StudySite of care and factors associated with mortality in unvaccinated Australian aged care residents during COVID-19 outbreaks.
Residential InReach presents an alternative to hospital admission for aged care residents swabbed for coronavirus disease 2019 (COVID-19), although relative outcomes remain unknown. ⋯ Unvaccinated aged care residents meeting COVID-19 testing criteria seen by InReach during a pandemic experience high mortality rates, including with negative swab result. Residents remaining within-facility (with InReach) experienced similar adjusted mortality odds to residents transferred to hospital for public health/facility-based reasons, and lower than those transferred for clinical acuity.
-
Internal medicine journal · May 2023
Case ReportsCost-effectiveness of Screening for Paroxysmal Atrial Fibrillation in Patients undergoing Echocardiography.
Screening for atrial fibrillation is recommended for patients > 65 years on current guidelines. Targeted screening may be more efficient, however the appropriate location for screening programs has not been well defined. Our aim was to compare the cost-effectiveness of unselected electrocardiographic (ECG) screening for atrial fibrillation (AF), and selective screening based on an abnormal echocardiogram. ⋯ In patients with a previous echocardiogram, AF screening of those with baseline clinical and imaging risk parameters is more cost-effective than age-based screening.
-
Internal medicine journal · May 2023
Excess Burden of Critical Illness Related to Inflammatory Bowel Disease.
Although inflammatory bowel disease (IBD) is associated with major morbidity and mortality, few studies have evaluated its associated burden of critical illness. ⋯ Patients with IBD suffer a major burden of critical illness.
-
Internal medicine journal · May 2023
Non-beneficial resuscitation during in-hospital cardiac arrests in a metropolitan teaching hospital.
There is increasing recognition that a proportion of hospitalised patients receive non-beneficial resuscitation, with the potential to cause harm. ⋯ Over one in seven resuscitation attempts were non-beneficial. MET reviews and specialist ward rounds provide opportunities to improve the documentation and visibility of NFR status.
-
Internal medicine journal · May 2023
CoBRA: COde Blue Retrospective Audit in a Metropolitan Hospital.
Inhospital cardiac arrest (IHCA) is an uncommon but challenging problem. ⋯ IHCA is uncommon and is associated with high mortality. IHCA prevalence was unchanged after the introduction of a dedicated MET service. Factors associated with improved survival to hospital discharge were initial rhythm VT or VF, cardiac monitoring and shorter resuscitation times.