Internal medicine journal
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Internal medicine journal · Feb 2022
ReviewMachine Learning in the Prediction of Medical Inpatient Length of Stay.
Length of stay (LOS) estimates are important for patients, doctors and hospital administrators. However, making accurate estimates of LOS can be difficult for medical patients. This review was conducted with the aim of identifying and assessing previous studies on the application of machine learning to the prediction of total hospital inpatient LOS for medical patients. ⋯ The variable performance reported by the studies identified in this review supports the need for further research of the utility of machine learning in the prediction of total inpatient LOS in medical patients. Future studies should follow and report a more standardised methodology to better assess performance and to allow replication and validation. In particular, prospective validation studies and studies assessing the clinical impact of such machine learning models would be beneficial.
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Internal medicine journal · Feb 2022
No Fever, No Worries? A Retrospective Audit of Bacteraemic Patients in the Emergency Department.
Early identification and treatment of serious infections improve clinical outcomes. Previous studies have found that septic patients without fever are more likely to die than those with fever, due to delay in antibiotic administration. ⋯ There was no significant difference in receipt of antibiotics within 4 h or 24 h ED arrival between the febrile and afebrile groups. However, afebrile patients experienced higher 30-day mortality. While most bacteraemic patients received antibiotics within 24 h, only half received antibiotics within 4 h, representing a key area for improvement.
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Internal medicine journal · Feb 2022
NSW Cannabis Medicines Advisory Service preliminary survey results - Enquirer perceptions and patient outcomes.
In 2018, an innovative, State government-funded cannabis medicines drug information service was established for health professionals in New South Wales (NSW). The NSW Cannabis Medicines Advisory Service (CMAS) provides expert clinical guidance and support to medical practitioners considering prescribing a cannabis medicine to their patient(s). ⋯ Preliminary findings highlight the impact of an innovative cannabis medicines drug information service in supporting health professional clinical practice in an area of rapid knowledge translation. Quality assurance data indicate that the service is perceived well by the majority of enquirers. Patient outcomes data across a wide range of indications suggest some effectiveness and a reasonable safety profile for prescribed cannabis medicines for most patients.
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Internal medicine journal · Feb 2022
Death determination, organ donation and the importance of the Dead Donor Rule following withdrawal of life-sustaining treatment: A survey of community opinions.
Background: Organ donation (OD) following circulatory determination of death (DCDD) is an increasing source of transplant organs but little is known about community opinions on treatment withdrawal, determination of death and acceptance of OD in DCDD. ⋯ We found high levels of support for treatment withdrawal in severe brain injury and when requested by a quadriplegic patient. While there was variable agreement with the timing of death determination and with OD under anaesthesia, support for OD was high in both scenarios. For many people death determination prior to OD may not be of paramount importance.
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Social distancing was the predominant strategy used to mitigate the spread of Coronavirus disease 2019 (COVID-19) at the start of the COVID-19 pandemic. ⋯ The incidences of streptococcal bacteraemia and bacteraemia of organisms transmitted through respiratory secretions were lower when there were social distancing restrictions. Adopting measures of social distancing may decrease the morbidity from bacteraemia caused by oropharynx and respiratory bacteria.