Comparing the Clinical Frailty Scale and an International Classification of Diseases-10 Modified Frailty Index in Predicting Long-Term Survival in Critically Ill Patients.

Unlabelled: The Clinical Frailty Scale (CFS) is the most used frailty measure in intensive care unit (ICU) patients. Recently, the modified frailty index (mFI), derived from 11 comorbidities has also been used. It is unclear to what degree the mFI is a true measure of frailty rather than comorbidity.

Impact of frailty on clinical outcomes in patients with and without COVID-19 pneumonitis admitted to intensive care units in Australia and New Zealand: a retrospective registry data analysis.

Background: It is unclear if the impact of frailty on mortality differs between patients with viral pneumonitis due to COVID-19 or other causes. We aimed to determine if a difference exists between patients with and without COVID-19 pneumonitis.

Methods: This multicentre, retrospective, cohort study using the Australian and New Zealand Intensive Care Society Adult Patient Database included patients aged ≥ 16 years admitted to 153 ICUs between 01/012020 and 12/31/2021 with admission diagnostic codes for viral pneumonia or acute respiratory distress syndrome, and Clinical Frailty Scale (CFS).

Vascular surgery patients in intensive care: a bi-national cohort study over 15 years.

Background: To describe the characteristics and outcomes of patients admitted to Intensive Care following vascular surgery, and their subsequent usage of Intensive Care resources, over a 15-year period in Australia and New Zealand.

Methods: This was a retrospective, bi-national study of 69 676 adult patients admitted to 179 Intensive Care Unit (ICUs) following vascular surgery between January 2005 and December 2019, using the Australian and New Zealand Intensive Care Society Adult Patient Database.

Results: The proportion of ICU bed days used by vascular surgery patients decreased during the study period from 3.

Treatment limitations and clinical outcomes in critically ill frail patients with and without COVID-19 pneumonitis.

Background: The presence of treatment limitations in patients with frailty at intensive care unit (ICU) admission is unknown. We aimed to evaluate the presence and predictors of treatment limitations in patients with and without COVID-19 pneumonitis in those admitted to Australian and New Zealand ICUs.

Methods: This registry-based multicenter, retrospective cohort study included all frail adults (≥16 years) with documented clinical frailty scale (CFS) scores, admitted to ICUs with admission diagnostic codes for viral pneumonia or acute respiratory distress syndrome (ARDS) over 2 years between January 01, 2020 and December 31, 2021.

Quality measurement and surveillance platforms in critically ill children: A scoping review.

Background/aim: The objective of this study was to describe current surveillance platforms which support routine quality measurement in paediatric critical care.

Method: Scoping review. The search strategy consisted of a traditional database and grey literature search as well as expert consultation.

Variation in Bed-to-Physician Ratios During Weekday Daytime Hours in ICUs in Australia and New Zealand.

Objectives: To determine common "bed-to-physician" ratios during weekday hours across ICUs and assess factors associated with variability in this ratio.

Design: Retrospective cohort study.

Setting: All ICUs in Australia/New Zealand that participated in a staffing survey administered in 2017-2018.

Temporal changes in the epidemiology of sepsis-related intensive care admissions from the emergency department in Australia and New Zealand.

Objectives: The Australasian Resuscitation in Sepsis Evaluation (ARISE) study researched septic shock treatment within EDs. This study aims to evaluate whether: (i) conduct of the ARISE study was associated with changes in epidemiology and care for adults (≥18 years) admitted from EDs to ICUs with sepsis in Australia and New Zealand; and (ii) such changes differed among 45 ARISE trial hospitals compared with 120 non-trial hospitals.

Methods: Retrospective study using interrupted time series analysis in three time periods; 'Pre-ARISE' (January 1997 to December 2007), 'During ARISE' (January 2008 to May 2014) and 'Post-ARISE' (June 2014 to December 2017) using data from the Australian and New Zealand Intensive Care Society Adult Patient Database.

Defining ICD-10 surrogate variables to estimate the modified frailty index: a Delphi-based approach.

Background: There are currently no validated globally and freely available tools to estimate the modified frailty index (mFI). The widely available and non-proprietary International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) coding could be used as a surrogate for the mFI. We aimed to establish an appropriate set of the ICD-10 codes for comorbidities to be used to estimate the eleven-variable mFI.

Admissions of Children and Adolescents With Deliberate Self-harm to Intensive Care During the SARS-CoV-2 Outbreak in Australia.

Importance: Identification of potential indirect outcomes associated with the COVID-19 pandemic in the pediatric population may be essential for understanding the challenges of the current global public health crisis for children and adolescents.

Objective: To investigate whether the SARS-CoV-2 outbreak and subsequent effective public health measures in Australia were associated with an increase in admissions to intensive care units (ICUs) of children and adolescents with deliberate self-harm (DSH).

Design, Setting, And Participants: This national, multicenter cohort study was conducted using the Australian data subset of the binational Australian and New Zealand Paediatric Intensive Care registry, a collaborative containing more than 200 000 medical records with continuous contributions from all 8 Australian specialist, university-affiliated pediatric ICUs, along with 1 combined neonatal-pediatric ICU and 14 general (adult) ICUs in Australia.

Improved survival of cirrhotic patients with infections in Australian and New Zealand ICUs between 2005 and 2017.

Background & Aims: Changes in outcomes of cirrhotic patients admitted to intensive care units (ICUs) with infections are poorly understood. We aimed to describe changes over time in outcomes for such patients and to compare them to other ICU admissions.

Methods: Analysis of consecutive admissions to 188 ICUs between 2005 and 2017 as recorded in the Australian and New Zealand Intensive Care Society Centre for Outcome and Research Evaluation Adult Patient Database.

Comparison of the predictive ability of clinical frailty scale and hospital frailty risk score to determine long-term survival in critically ill patients: a multicentre retrospective cohort study.

Background: The Clinical Frailty Scale (CFS) is the most commonly used frailty measure in intensive care unit (ICU) patients. The hospital frailty risk score (HFRS) was recently proposed for the quantification of frailty. We aimed to compare the HFRS with the CFS in critically ill patients in predicting long-term survival up to one year following ICU admission.

Trends and risk factors for omission of early thromboprophylaxis in Australian and New Zealand ICUs between 2009 and 2020.

Purpose: Venous thromboembolism (VTE) prophylaxis is effective in reducing VTE events; however, it is underutilized in critically ill patients. We examined trends and risk factors for omission of early thromboprophylaxis within the first 24 h after admission in Australian and New Zealand intensive care units (ICUs) between 2009 and 2020.

Methods: Retrospective analysis of data from the Australian New Zealand Intensive Care Society Adult Patient Database.

The Global Open Source Severity of Illness Score (GOSSIS).

Objectives: To develop and demonstrate the feasibility of a Global Open Source Severity of Illness Score (GOSSIS)-1 for critical care patients, which generalizes across healthcare systems and countries.

Design: A merger of several critical care multicenter cohorts derived from registry and electronic health record data. Data were split into training (70%) and test (30%) sets, using each set exclusively for development and evaluation, respectively.

Long-term outcomes of hospital survivors following an ICU stay: A multi-centre retrospective cohort study.

Background: The focus of much Intensive Care research has been on short-term survival, which has demonstrated clear improvements over time. Less work has investigated long-term survival, and its correlates. This study describes long-term survival and identifies factors associated with time to death, in patients who initially survived an Intensive Care admission in Victoria, Australia.

The impact of obesity on outcomes of patients admitted to intensive care after cardiac arrest.

Purpose: Studies examining the association between obesity and mortality in cardiac arrest patients have been conflicting which might either be due to residual confounding, or a reliance on estimating the conditional effects rather than the marginal (causal) effects of obesity. We estimated the conditional and causal effects of obesity on mortality in cardiac arrest patients using the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD).

Materials And Methods: This retrospective registry-based cohort study from ICUs of Australia and New Zealand included all ICU patients admitted with cardiac arrest between 2010 and 2020 with height and weight data recorded.

Educational Outcomes of Childhood Survivors of Critical Illness-A Population-Based Linkage Study.

Objectives: Major postintensive care sequelae affect up to one in three adult survivors of critical illness. Large cohorts on educational outcomes after pediatric intensive care are lacking. We assessed primary school educational outcomes in a statewide cohort of children who survived PICU during childhood.

Impact of frailty on persistent critical illness: a population-based cohort study.

Purpose: Acute illness severity predicts mortality in intensive care unit (ICU) patients, however, its predictive value decreases over time in ICU. Typically after 10 days, pre-ICU (antecedent) characteristics become more predictive of mortality, defining the onset of persistent critical illness (PerCI). How patient frailty affects development and death from PerCI is unknown.

Timely goals of care documentation in patients with frailty in the COVID-19 era: a retrospective multi-site study.

Background: Older frail patients are more likely to have timely goals of care (GOC) documentation than non-frail patients.

Aims: To investigate whether timely documentation of GOC within 72 h differed in the context of the COVID-19 pandemic (2020), compared with the pre-COVID-19 era (2019) for older frail patients.

Methods: Multi-site retrospective cohort study was conducted in two public hospitals where all consecutive frail adult patients aged ≥65 years were admitted under medical units for at least 24 h between 1 March 31 and October in 2019 and between 1 March and 31 October 2020 were included.

Association of patient-to-intensivist ratio with hospital mortality in Australia and New Zealand.

Purpose: The impact of intensivist workload on intensive care unit (ICU) outcomes is incompletely described and assessed across healthcare systems and countries. We sought to examine the association of patient-to-intensivist ratio (PIR) with hospital mortality in Australia/New Zealand (ANZ) ICUs.

Methods: We conducted a retrospective study of adult admissions to ANZ ICUs (August 2016-June 2018) using two cohorts: "narrow", based on previously used criteria including restriction to ICUs with a single daytime intensivist; and "broad", refined by individual ICU daytime staffing information.

Increasing ICU capacity to accommodate higher demand during the COVID-19 pandemic.

Objectives: To describe the short term ability of Australian intensive care units (ICUs) to increase capacity in response to heightened demand caused by the COVID-19 pandemic.

Design: Survey of ICU directors or delegated senior clinicians (disseminated 30 August 2021), supplemented by Australian and New Zealand Intensive Care Society (ANZICS) registry data.

Setting: All 194 public and private Australian ICUs.

Association Between Urine Output and Mortality in Critically Ill Patients: A Machine Learning Approach.

Objectives: Current definitions of acute kidney injury use a urine output threshold of less than 0.5 mL/kg/hr, which have not been validated in the modern era. We aimed to determine the prognostic importance of urine output within the first 24 hours of admission to the ICU and to evaluate for variance between different admission diagnoses.