Objective: Intensive care (ICU) beds are scarce and decision-making regarding admission is complex and multi-factorial. This study aimed to characterise differences in admission decision making between Australia and New Zealand and compare to previous data to establish changes over time.
Design: Online Survey.
Setting And Participants: An online survey was distributed to Australian and New Zealand intensive care doctors measuring triage behaviours in the last week and responses to ICU triage scenarios.
Main Outcome Measures: Perceived ICU admission behaviours.
Results: 103 responses were obtained, 83(80.6%) from Australia and 97 (94.2%) from specialist intensivists. The median number of triage decisions and patients declined were 6-10 and 1-5 respectively. No difference was noted in the role of ICU bed capacity in decision making between Australia and New Zealand. Compared to Australian intensivists, New Zealand intensivists were less likely to admit a patient: with relapsed acute myeloid leukaemia (AML) and acute respiratory distress syndrome (ARDS)(p=0.03), with persistent vegetative state and community acquired (p=0.02) or iatrogenic (p=0.03) pneumonia. Compared to respondents in 2009 (n=238), 2023 respondents were more likely to admit a patient: with a severe intracranial bleed who may become braindead (p=0.005), with relapsed AML and ARDS (p=0.02), with stroke for palliative care (p<0.001); and less likely to admit a patient with persistent vegetative state and iatrogenic pneumonia (p=0.03). In a multivariable analysis, respondents from Australian compared to New Zealand and from 2023 compared to 2009 were more likely to indicate they would admit patients to the ICU in the scenarios described (p<0.001 for both comparisons).
Conclusions: Our study suggests that New Zealand intensivists may apply more restrictive ICU admission criteria than Australian intensivists. Changes in attitudes to admission since 2009 may reflect increased awareness of the importance of facilitating organ donation and the role of ICU as providers of palliative care.
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http://dx.doi.org/10.1016/j.ccrj.2023.10.001 | DOI Listing |
J Med Internet Res
January 2025
Hospital Administration, Ramaiah Memorial Hospital, Bengaluru, Karnataka, India.
Background: Monitoring vital signs in hospitalized patients is crucial for evaluating their clinical condition. While early warning scores like the modified early warning score (MEWS) are typically calculated 3 to 4 times daily through spot checks, they might not promptly identify early deterioration. Leveraging technologies that provide continuous monitoring of vital signs, combined with an early warning system, has the potential to identify clinical deterioration sooner.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
Department of Health Services Research Management, AI and Digital Health Lab (Centre for Healthcare Innovation Research), City St George's University, London, United Kingdom.
User trust is pivotal for the adoption of digital health systems interventions (DHI). In response, numerous trust-building guidelines have recently emerged targeting DHIs such as artificial intelligence. The common aim of these guidelines aimed at private sector actors and government policy makers is to build trustworthy DHI.
View Article and Find Full Text PDFNeurology
February 2025
Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
Pathogenic variants in cause congenital muscular dystrophy through hypoglycosylation of alpha-dystroglycan (OMIM #615350). The established phenotypic spectrum of GMPPB-related disorders includes recurrent rhabdomyolysis, limb-girdle muscular dystrophy, neuromuscular transmission abnormalities, and congenital muscular dystrophy with variable brain and eye anomalies. We report a 9-month-old male infant with congenital muscular dystrophy, infantile spasms, and compound heterozygous pathogenic variants (c.
View Article and Find Full Text PDFArq Bras Cir Dig
January 2025
Pontificia Universidad Católica de Chile, Department of Digestive Surgery - Santiago, Chile.
Background: Perihilar cholangiocarcinoma presents unique challenges in perioperative management, requiring a comprehensive approach to optimize patient outcomes.
Aims: This case study focuses on the multidisciplinary management and innovative interventions performed in the perioperative care of a patient with hilar cholangiocarcinoma.
Methods: A comprehensive assessment and treatment strategy involving neoadjuvant therapy and interventional radiology techniques were implemented.
Epidemiol Serv Saude
January 2025
Universidade Federal de Pernambuco, Programa de Pós-Graduação em Gerontologia, Recife, PE, Brasil.
Objective: To describe how transgenderism is studied in research on the health of older adults.
Methods: This was a systematic literature review, with searches conducted in September 2022 across the LILACS, MEDLINE/ PubMed, Embase, Web of Science and Scopus databases. The articles were selected independently by two reviewers.
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