Ethnic Disparities in CT Aortography Use for Diagnosing Acute Aortic Syndrome.

Purpose: To determine whether CT aortography was performed in proportion to patient risk for acute aortic syndrome (AAS) and incidence of AAS for different ethnic groups.

Materials And Methods: All atraumatic thoracic aorta CT aortographic examinations performed in adults (age > 15 years) suspected of having AAS between January 2009 and December 2019 at Auckland City Hospital (New Zealand) were included. Patients were risk stratified using the aortic dissection detection risk score (ADD-RS).

The association of socioeconomic deprivation with access and survival after hematopoietic stem cell transplantation in New Zealand.

Background: Socioeconomic deprivation (SED) is a risk factor for reduced survival of hematopoietic stem cell transplant (HSCT) recipients. This study aimed to evaluate access and long-term survival of HSCT recipients.

Methods: This was a hospital HSCT Registry-based retrospective cohort study.

Trends in computed tomography aortography and acute aortic syndrome in an emergency department within Aotearoa New Zealand.

Objective: Acute aortic syndrome (AAS) comprises a triad of life-threatening aortic conditions that are difficult to diagnose because of their non-specific clinical presentations. Contrast-enhanced computed tomography aortography (CTA) has a high sensitivity and specificity for these conditions. However, under- and over-investigation of patients with suspected AAS using CTA carries significant risk.

Accuracy of ultrasound in the estimation of customised birth weight in a public hospital service.

Introduction: Studies have shown that ultrasound estimated foetal weight (EFW) in small for gestational age (SGA) babies tends to be less-accurate when compared to appropriate (AGA) and large (LGA) for gestational age babies. We aimed to analyse the accuracy of ultrasound EFW overall, and by customised birth weight centile category (severe SGA, SGA, AGA, LGA). Also, the accuracy of estimating the centile category using calculated customised EFW centiles.

Accuracy of ultrasound in estimating fetal weight in New Zealand.

Introduction: Ultrasound estimation of fetal weight is an important factor guiding antenatal management. We aimed to review the accuracy of ultrasound in predicting fetal weight and birthweight category and identify influencing factors.

Methods: We performed a retrospective study of term pregnant women who underwent ultrasound within 7 days of delivery at National Women's Health between January 2019 and January 2020.

Socioeconomic inequality: accessibility and outcomes after renal transplantation in New Zealand.

Background: Socioeconomic deprivation (SED) is a risk factor for worse outcomes after renal transplantation (RTx). This study aimed to evaluate access to RTx in different SED strata of the New Zealand population. We also assessed patient survival, acute cellular allograft rejection (AR) and allograft loss.

Impact of socioeconomic deprivation on incidence and outcomes of acute type A aortic dissection repair in New Zealand.

Background: Socioeconomic deprivation (SED) has been associated with increased 30-day mortality and reduced long-term survival after surgical repair of acute type A aortic dissection (ATAAD). The study aimed to determine the incidence rate ratio of ATAAD in New Zealand population with higher and lower SED indices and to evaluate any association between SED and outcomes after ATAAD repair.

Methods: This was a retrospective cohort study.

Thoracic manifestations of inhalational injury caused by the Whakaari/White Island eruption.

Introduction: Thoracic imaging of people who have survived exposure to a volcanic pyroclastic flow has not been described. In December 2019, an active volcano in New Zealand erupted with loss of life and severe burns to groups of people who were within one kilometre of a new fissure. Our aim was to describe the range of pulmonary abnormality in patients admitted to the Burns unit at Middlemore Hospital.

Impact of the Duration of Global Cardiac Ischaemia on Outcomes of Acute Type A Aortic Dissection Repair.

Background: The current management of acute type A aortic dissection (ATAD) repair does not consider the safe duration of cardiac ischaemia as an operative strategy. We aimed to evaluate whether the duration of cardiac ischaemia during ATAD repair can predict operative mortality and to determine the optimum cardiac ischaemia time that is associated with better outcomes.

Methods: This was a retrospective observational study.

Diagnostic inflammatory markers of acute cholangitis in liver transplant recipients.

Background: Acute cholangitis (AC) after liver transplantation occurs in 8-12% patients and remains a significant cause of patients' morbidity and mortality. The 2018 Tokyo guidelines use white blood cell count and C-reactive protein (CRP) as diagnostic criteria in AC. However, these and other common inflammatory markers have not been assessed in immunosuppressed liver transplant (LT) recipients with AC.

Regional healthcare costs and burden of injury associated with electric scooters.

Background: The introduction of shared electric scooters (e-scooters) to New Zealand has resulted in a large number of injuries. Within the past year, there have been studies addressing some of the impact of these e-scooter injuries, but none have included outpatient data or total regional costs.

Methods: This was a retrospective review of e-scooter associated injuries presenting to Auckland region healthcare providers in the seven months since their introduction using Accident Compensation Corporation (ACC) Claims data.

Screening acute cholangitis patients for sepsis.

Background: Acute cholangitis (AC) complicated by septic shock is associated with 40% mortality. The best screening method for diagnosing sepsis in patients with AC is unknown. In this study, we aimed to compare the discriminative powers of systemic inflammatory response syndrome criteria (SIRS test) and the 2018 Tokyo Guidelines for moderate cholangitis (TG18 test) in screening AC patients for sepsis and to estimate their predictive abilities.

Socio-Economic Disparity is Not Linked to Outcome Following Heart Transplantation in New Zealand.

Background: Socio-economic deprivation (SED) is emerging as a risk factor for acute graft rejection (AR) and reduced survival of heart transplant (HT) recipients. The study aim was to evaluate any association between SED status of HT recipients and the development of early AR and long-term survival in New Zealand.

Methods: This was a retrospective cohort study.

Impact of e-scooter injuries on Emergency Department imaging.

Introduction: Since the introduction of a shared e-scooter service to Auckland in October there have been multiple media reports of associated injuries, but no quantitation of the number or severity of these injuries, or the impact on hospital emergency department services in Auckland.

Methods: We performed a retrospective chart review on all patients referred to Auckland hospital ED radiology with the indication containing 'e-scooter' between 15 August 2018 and 15 December 2018. All requests were screened to ensure that the injury was caused by an e-scooter.

Sonographic findings in acute puerperal endometritis.

Purpose: To evaluate the reliability of the sonographic subserosal hypoechoic rim sign and endomyometrial junction indistinctness in distinguishing patients with acute puerperal endometritis from other common postpartum complications, particularly those with retained products of conception.

Methods: Radiographic coding identified all patients presenting to Auckland City Hospital over a 12-month period between 1 March 2016 and 28 February 2017 who had pelvic ultrasound scans to assess for postpartum complications. Clinical notes were reviewed to identify those patients with a clinical diagnosis of acute endometritis.

Diagnostic inflammatory markers in acute cholangitis.

Background: The 2018 Tokyo guidelines for acute cholangitis (AC) use white cell count (WCC) as one of the diagnostic criteria. However, the 2018 Tokyo guidelines grading does not provide guidance for AC patients with normal WCC. In this situation, other inflammatory biomarkers also can be used to diagnose AC and grade severity, but their diagnostic values are yet undetermined.

Sonographic findings in acute puerperal endometritis: The hypoechoic rim sign and endomyometrial junction indistinctness.

Purpose: To evaluate the accuracy of the sonographic subserosal hypoechoic rim sign and endomyometrial junctional indistinctness in identifying patients with acute endometritis during the puerperal period.

Methods: Radiologic coding identified the ultrasound scans of all patients presenting to Auckland City Hospital between January 2014 and February 2016 who were diagnosed clinically as having acute endometritis during the post-partum or post-abortion period. After exclusion criteria were applied, the ultrasound scans of 31 patients with acute endometritis and 32 healthy controls were randomised and anonymised.