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Definitions, epidemiology, and outcomes of persistent/chronic critical illness: a scoping review for translation to clinical practice.
Crit Care
December 2024
Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
Background: Medical advances in intensive care units (ICUs) have resulted in the emergence of a new patient population-those who survive the initial acute phase of critical illness, but require prolonged ICU stays and develop chronic critical symptoms. This condition, often termed Persistent Critical Illness (PerCI) or Chronic Critical Illness (CCI), remains poorly understood and inconsistently reported across studies, resulting in a lack of clinical practice use. This scoping review aims to systematically review and synthesize the existing literature on PerCI/CCI, with a focus on definitions, epidemiology, and outcomes for its translation to clinical practice.
View Article and Find Full Text PDFGestational Age-Specific Stillbirth Rates: Are We Using the Right Denominator?
Paediatr Perinat Epidemiol
December 2024
NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - The University of Queensland, Brisbane, Queensland, Australia.
Article Synopsis
- Stillbirths happen globally every 17 seconds, leading to almost 2 million cases annually, and the common measure used, stillbirth rate, often overlooks important gestational age-specific trends.
- This study focused on analyzing stillbirth trends in Australia from 1998 to 2018, using three different methodologies to calculate stillbirth rates based on gestational age and risk: GS-SBR, FAR, and ccFAR.
- Results showed that the FAR and ccFAR measures provided a more accurate understanding of stillbirth risk as pregnancy progresses, highlighting distinct trends that could assist clinicians in their decision-making.
Applying population-specific incidence prevalence ratio benchmarks to monitor the Australian HIV epidemic: an epidemiological analysis.
J Int AIDS Soc
December 2024
The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Article Synopsis
- Australia struggles to effectively monitor the HIV epidemic due to insufficient population data, prompting this study to use incidence prevalence ratios (IPRs) to assess the epidemic trends among specific groups: men who have sex with men, women, and people who inject drugs.
- The study employed mathematical modeling to create IPRs from various data sources, comparing them against benchmarks based on life expectancy after HIV acquisition, illuminating trends from 2015 to 2022.
- The findings showed a significant decline in IPRs across all groups, with overall rates dropping by 80%, and many groups surpassing benchmarks, indicating a positive trend in managing HIV transmission in Australia.
Background: The win ratio (WR) is an emerging alternative for reporting composite outcomes, prioritizing clinically significant events such as mortality while incorporating surrogate measures. However, its benefits should be weighed against limitations, particularly the influence of lower hierarchical outcomes. This secondary analysis of the PARAGLIDE-HF trial performed a WR sensitivity analysis using a modified hierarchical composite outcome to assess the utility of WR sensitivity analysis and the efficacy of sacubitril/valsartan versus valsartan.
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