Screening for End-of-Life in Acute Hospitals: A Cross-Sectional Survey.

Background: Patients are frequently admitted to hospital in the last year of life. Actively recognising patients at this stage gives the opportunity to plan future care.

Methods: We performed a cross-sectional survey of all acute medical and surgical inpatients at one tertiary hospital.

A framework for local-level economic evaluation to inform implementation decisions: health service interventions to prevent hospital-acquired hypoglycemia.

Objectives: Published evidence on health service interventions should inform decision-making in local health services, but primary effectiveness studies and cost-effectiveness analyses are unlikely to reflect contexts other than those in which the evaluations were undertaken. A ten-step framework was developed and applied to use published evidence as the basis for local-level economic evaluations that estimate the expected costs and effects of new service intervention options in specific local contexts.

Methods: Working with a multidisciplinary group of local clinicians, the framework was applied to evaluate intervention options for preventing hospital-acquired hypoglycemia.

Key aspects of teaching that affect perceived preparedness of medical students for transition to work: insights from the COVID-19 pandemic.

Background: The self-perceived preparedness of medical students to transition into practising junior doctors has implications for patient safety, graduate well-being and development of professional identity.

Aims: To examine the impact of changes to final-year education and placements and determine key elements that contribute to self-perceived preparedness for transition to work.

Methods: An online survey among final-year medical students at one Australian medical school in 2020 (the cohort most affected by the coronarvirus disease 2019 [COVID-19] pandemic), exploring overall self-perceived preparedness and specific competencies, including questions in previous Australian Medical Council/Medical Board of Australia annual national surveys.

The Impact of Weight Loss Prior to Hospital Readmission.

Hospital readmissions place a burden on hospitals. Reducing the readmission number and duration will help reduce the burden. Weight loss might affect readmission risk, especially the risk of an early (<30 days) readmission.

Impact of Malnutrition on Clinical Outcomes of Acutely Hospitalised Heart Failure Patients at Two Tertiary Hospitals in Australia: An Observational Study.

Background: Malnutrition is common in patients with heart failure (HF) but is often neglected, despite guidelines suggesting that all hospitalised patients should undergo nutritional screening within 24-hours of admission.

Aims: This study investigated the nutritional screening rates and determined the immediate and long-term clinical outcomes in patients with HF admitted at two tertiary hospitals in Australia.

Methods: Nutritional screening was assessed by the Malnutrition Universal Screening Tool (MUST) completion rates.

Using electronic admission data to monitor temporal trends in local medication use: Experience from an Australian tertiary teaching hospital.

Medication usage varies according to prescribing behavior, professional recommendations, and the introduction of new drugs. Local surveillance of medication usage may be useful for understanding and comparing prescribing practices by healthcare providers, particularly in countries such as Australia that are in the process of enhancing nationwide data linkage programs. We sought to investigate the utility of electronic hospital admission data to investigate local trends in medication use, to determine similarities and differences with other Australian studies, and to identify areas for targeted interventions.

Benefits of heart failure-specific pharmacotherapy in frail hospitalised patients: a cross-sectional study.

Objectives: Up to 50% of heart failure (HF) patients may be frail and have worse clinical outcomes than non-frail patients. The benefits of HF-specific pharmacotherapy (beta-blockers, ACE-inhibitors/angiotensin-receptor-blockers and mineralocorticoid-receptor-antagonist) in this population are unclear. This study explored whether HF-specific pharmacotherapy improves outcomes in frail hospitalised HF patients.

Hospital Acquired Complications in South Australian major public hospitals.

The prevalence of Hospital Acquired Complications (HACs) within major hospitals and intensive care units (ICUs) is often used as an indication of care quality. We performed a retrospective cohort study of acute care separations from four adult public hospitals in the state of South Australia, Australia. Data were derived from the Integrated South Australian Activity Collection (ISAAC) database, subdivided into those admitted to ICU or non-ICU (Ward) in tertiary referral or (other major) metropolitan hospitals.

Validity of the Malnutrition Universal Screening Tool for Evaluation of Frailty Status in Older Hospitalised Patients.

The malnutrition-universal-screening-tool (MUST) is commonly used for screening malnutrition in hospitalised patients but its utility in the detection of frailty is unknown. This study determined the utility of MUST in detection of frailty in older hospitalised patients. This prospective-study enrolled 243 patients ⩾65 years in a tertiary-teaching hospital in Australia.

External Validation of the Hospital Frailty-Risk Score in Predicting Clinical Outcomes in Older Heart-Failure Patients in Australia.

Frailty is common in older hospitalised heart-failure (HF) patients but is not routinely assessed. The hospital frailty-risk score (HFRS) can be generated from administrative data, but it needs validation in Australian health-care settings. This study determined the HFRS scores at presentation to hospital in 5735 HF patients ≥ 75 years old, admitted over a period of 7 years, at two tertiary hospitals in Australia.

Relationship between Vitamin C Deficiency and Cognitive Impairment in Older Hospitalised Patients: A Cross-Sectional Study.

Vitamin C is a powerful antioxidant and facilitates neurotransmission. This study explored association between vitamin C deficiency and cognitive impairment in older hospitalised patients. This prospective study recruited 160 patients ≥ 75 years admitted under a Geriatric Unit in Australia.

Hospital-acquired complications: the relative importance of hospital- and patient-related factors.

Objective: To quantify the prevalence of hospital-acquired complications; to determine the relative influence of patient- and hospital-related factors on complication rates.

Design, Participants: Retrospective analysis of administrative data (Integrated South Australian Activity Collection; Victorian Admitted Episodes Dataset) for multiple-day acute care episodes for adults in public hospitals.

Setting: Thirty-eight major public hospitals in South Australia and Victoria, 2015-2018.

Trends in Frailty and Use of Evidence-Based Pharmacotherapy for Heart Failure in Australian Hospitalised Patients: An Observational Study.

Frailty increases morbidity and mortality in heart failure (HF) patients. Current risk-adjustment models do not include frailty-status and the relationship between frailty and pharmacotherapy is unclear. This study explored trends in frailty over time and its relationship with prescription of heart failure specific pharmacotherapy in hospitalised HF patients.

The Impact of Morbid Obesity on the Health Outcomes of Hospital Inpatients: An Observational Study.

Morbid obesity poses a significant burden on the health-care system. This study determined whether morbid obesity leads to worse health-outcomes in hospitalised patients. This retrospective-study examined nutritional data of all inpatients aged 18-79 years, with a body-mass-index (BMI) ≥ 18.

The overlap of frailty and malnutrition in older hospitalised patients: An observational study.

Background And Objectives: Frailty and malnutrition are geriatric syndromes with common risk-factors. Limited studies have investigated these two conditions simultaneously in hospitalised patients. This study investigated the overlap of frailty and malnutrition in older hospitalised patients.

Prevalence of Hypovitaminosis C and its Relationship with Frailty in Older Hospitalised Patients: A Cross-Sectional Study.

Frailty is common in older hospitalised patients and may be associated with micronutrient malnutrition. Only limited studies have explored the relationship between frailty and vitamin C deficiency. This study investigated the prevalence of vitamin C deficiency and its association with frailty severity in patients ≥75 years admitted under a geriatric unit.

Goal Attainment: A Clinically Meaningful Measure of Success of Botulinum Toxin-A Treatment for Lower Limb Spasticity in Ambulatory Patients.

Objectives: The objectives of this study were to evaluate whether botulinum toxin type A (BoNT-A) treatment for lower limb spasticity leads to patient goal attainment and identify factors associated with positive goal attainment and to assess the effect of BoNT-A treatment on patients' gait.

Design: Retrospective cohort study between June 2014 and February 2019.

Setting: Public outpatient spasticity clinic in a tertiary hospital.

Prevalence, characteristics and risk factors of frequently readmitted patients to an internal medicine service.

Background: Unplanned hospital readmissions (HRA), which have been used as key performance index of healthcare quality, are becoming more prevalent. They are associated with substantial financial burden to hospital systems and considerable impacts on patients' physical and mental health. Patients with frequent readmissions are not well studied.

Anaemia in elderly patients at discharge from intensive care and hospital.

Background And Objectives: Anaemia is common in the elderly and is recognized as a risk factor for several adverse outcomes in older adults, including hospitalization, morbidity and mortality. The study aims were to examine the prevalence of anaemia in elderly patients at discharge from the intensive care unit (ICU) and hospital.

Materials And Methods: Patient randomized under the INFORM trial and with an ICU admission were included.

Effectiveness of Oseltamivir in reducing 30-day readmissions and mortality among patients with severe seasonal influenza in Australian hospitalized patients.

Background: Worldwide, seasonal influenza causes significant mortality and poses a significant economic burden. Oseltamivir is an effective treatment, but benefits beyond immediate hospitalization are unknown.

Methods: This retrospective multicenter study included adult hospitalized influenza patients from two major teaching hospitals in Australia.

Prognostic impact of high sensitive troponin in predicting 30-day mortality among patients admitted to hospital with influenza.

Background: Worldwide, seasonal influenza causes significant mortality and severe infections may cause cardiac injury. High-sensitive-troponins (hsTnT) are sensitive and specific markers of myocardial damage. This study investigated the prognostic impact of hsTnT on 30-day mortality in hospitalised influenza patients.

Clinical characteristics and outcomes of influenza A and B virus infection in adult Australian hospitalised patients.

Background: Influenza B is often perceived as a less severe strain of influenza. The epidemiology and clinical outcomes of influenza B have been less thoroughly investigated in hospitalised patients. The aims of this study were to describe clinical differences and outcomes between influenza A and B patients admitted over a period of 4 years.

Characteristics and clinical outcomes of index versus non-index hospital readmissions in Australian hospitals: a cohort study.

Objective Risk factors and clinical outcomes of non-index hospital readmissions (readmissions to a hospital different from the previous admission) have not been studied in Australia. The present study compared characteristics and clinical outcomes between index and non-index hospital readmissions in the Australian healthcare setting. Methods This retrospective cohort study included medical admissions from 2012 to 2016 across all major public hospitals in South Australia.

Scleroderma renal crisis: observations from the South Australian Scleroderma Register.

Background: Scleroderma renal crisis (SRC) is a rare but feared complication with high morbidity and mortality. Its aetiopathogenesis is unclear.

Aim: To investigate epidemiological, serologic and clinical features of all patients with SRC listed on the population-based South Australian Scleroderma Register and to examine possible factors in aetiopathogenesis.

Healthcare costs and outcomes for patients undergoing tracheostomy in an Australian tertiary level referral hospital.

Objective: Patients undergoing tracheostomy represent a unique cohort, as often they have prolonged hospital stay, require multi-disciplinary, resource-intensive care, and may have poor outcomes. Currently, there is a lack of data around overall healthcare cost for these patients and their outcomes in terms of morbidity and mortality. The objective of the study was to estimate healthcare costs and outcomes associated in tracheostomy patients at a tertiary level hospital in South Australia.