318 results match your criteria: "Dandenong Hospital[Affiliation]"

The interplay between frailty status and persistent critical illness on the outcomes of patients with critical COVID-19: A population-based retrospective cohort study.

Aust Crit Care

November 2024

Department of Intensive Care, Frankston Hospital, 2 Hastings Road, Frankston, Victoria 3199, Australia; Peninsula Clinical School, Monash University, 2 Hastings Road, Frankston, Victoria 3199, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia; Department of Intensive Care, Dandenong Hospital, Monash Health, 135 David St, Dandenong, Victoria 3175, Australia.

Objectives: Persistent critical illness (PerCI) occurs when the patient's prolonged intensive care unit (ICU) stay results in complications that become the primary drivers of their condition, rather than the initial reason for their admission. Patients with frailty have a higher risk of developing and dying from PerCI. We aimed to investigate the interplay of frailty and PerCI in critically ill patients with COVID-19.

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Objective: Protocol to explore what is known about communication between critical care providers and patients and families from culturally and linguistically diverse backgrounds (defined as people who are either from minority ethnic groups, non-English-speaking backgrounds who may have diverse cultural, linguistic, spiritual and religious affiliations and opinions) about death, dying, end-of-life care and organ donation in the intensive care unit (ICU).

Introduction: Patients from culturally and linguistically diverse backgrounds experience barriers to optimised care when admitted to the ICU. These barriers appear to derive from differences in language, cultural, societal and ethical expectations between patients, their families and healthcare professionals.

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Background: Haemorrhoids remain a highly prevalent condition in Australia, affecting 39% of the adult Australian population. While haemorrhoidectomy remains the gold standard in the management of haemorrhoids, newer techniques such as haemorrhoid artery ligation-recto anal repair (HAL-RAR) are emerging as promising management modalities. We compare the efficacy of non-Doppler guided (non-DG) HAL-RAR versus Doppler-guided (DG) HAL-RAR in the management of haemorrhoids.

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Article Synopsis
  • * A total of 7189 admissions for severe anaphylaxis were analyzed, showing an increase in the percentage of such cases from 0.25% in 2012 to 0.43% in 2022, with very low mortality rates of 0.4% and 0.8% in ICU and hospital settings, respectively.
  • * Factors predicting in-hospital mortality included older age, higher SOFA scores, chronic immunosuppressive conditions, and a respiratory rate above 16
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Article Synopsis
  • * Key questions have emerged regarding differences between COVID-19 and non-COVID-19 respiratory failures, the role of personalized therapy, and alternative respiratory support options to intubation.
  • * The chapter discusses advances in understanding respiratory failure, the significance of international collaboration among medical professionals, and the need for skepticism when evaluating rapidly evolving medical evidence during a pandemic.
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The coronavirus disease 2019 (COVID-19) pandemic has unquestionably transformed the field of intensive care medicine. Never have we witnessed millions of patients develop acute respiratory failure in such a short span of time. This led to extensive resource constraints and difficulty in treating patients.

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Article Synopsis
  • Acute hypoxaemic respiratory failure (AHRF) is a significant cause for ICU admissions, comprising over 52% of patients, with differing mortality rates based on severity.
  • A study from 2005 to 2022 revealed that the survival rate has improved overall in ICUs, with in-hospital mortality decreasing from 13.3% to 8.2%, even amidst the high risks associated with severe AHRF.
  • Researchers emphasize the need for better identification of AHRF patients to manage and reduce the risk of deterioration effectively, as the healthcare impact of AHRF may be larger than previously understood.
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Frailty as a trigger for goals-of-care discussions in rapid response calls: A single-centre retrospective cohort study.

Aust Crit Care

August 2024

Department of Intensive Care, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Intensive Care Medicine, Dandenong Hospital, Monash Health, Dandenong, Victoria, Australia; Department of Intensive Care, Epworth HealthCare, Geelong, Victoria, Australia; Department of Medicine, Peninsula Clinical School, Monash University, Frankston, Victoria, Australia; Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Background: Timely goals-of-care (GOC) discussions are essential for end-of-life planning, particularly during acute hospital admissions, where ambiguity often persists. Frailty, prevalent in the ageing population and linked to adverse outcomes, underscores the need to align treatment strategies with quality of life. Recognising frailty as a trigger for GOC discussions during rapid response calls (RRCs) is critical for efficient resource management and improving patient outcomes.

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Purpose: Perioperative in-hospital cardiac arrests (Perioperative IHCAs) may have better outcomes than IHCAs in the ward (Ward IHCAs), due to enhanced monitoring and faster response. However, quantitative comparisons of their long-term outcomes are lacking, posing challenges for prognostication.

Methods: This retrospective multicentre study included adult intensive care unit (ICU) admissions from theatre/recovery or wards with a diagnosis of cardiac arrest between January 2018 and March 2022.

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Article Synopsis
  • The study compares two surgical methods (costal-osteochondral graft (COG) and medial femoral trochlea (MFT) graft) for treating fragmented fractures of the scaphoid with over two years of follow-up.
  • Both methods showed similar outcomes in terms of pain and wrist function, but there was a distinct radiographic finding where COG patients had evidence of arthritis, while MFT patients did not.
  • MFT patients experienced knee pain as a complication, while COG patients faced the risk of developing wrist arthritis over time.
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Simplifying the Decision-Making Process in the Treatment of Kienböck's Disease.

J Wrist Surg

August 2024

Division of Hand Surgery, Department of Orthopaedic Surgery, Dandenong Hospital, Monash Health, Melbourne, Victoria, Australia.

 In recent years, the classification and treatment algorithm for adult Kienböck's disease (KD) has expanded. However, the priority of the investigations done in determining its management has not been discussed, as not every patient with KD requires magnetic resonance imaging (MRI) or wrist arthroscopy.  We discuss the role of these investigations and emphasize the importance of computed tomography (CT) imaging in evaluating the cortical integrity of the lunate and its role in the decision-making process and management of KD.

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Impact of frailty on long-term survival in patients discharged alive from hospital after an ICU admission with COVID-19.

Crit Care Resusc

March 2024

Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Article Synopsis
  • A study was conducted to explore how frailty affects long-term survival in patients who were admitted to the ICU due to COVID-19, focusing on those discharged alive.
  • Researchers analyzed data from 4028 patients across 118 ICUs in New Zealand and Australia, categorizing them based on their frailty levels using the Clinical Frailty Scale (CFS).
  • The results indicated that both mildly frail and moderately-to-severely frail patients had significantly higher mortality rates within two years post-discharge compared to those who were not frail, highlighting the importance of recognizing frailty in ICU care.
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Female surgeons have increased rates of infertility and pregnancy complications compared to the general population. Reported infertility rates in surgeons are 32% compared to 10.9% in the general population.

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Surgical procedures, including nerve reconstruction and end-organ muscle reinnervation, have become more prominent in the prosthetic field over the past decade. Primarily developed to increase the functionality of prosthetic limbs, these surgical procedures have also been found to reduce postamputation neuropathic pain. Today, some of these procedures are performed more frequently for the management and prevention of postamputation pain than for prosthetic fitting, indicating a significant need for effective solutions to postamputation pain.

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Has the rescheduling of modified-release paracetamol in Australia affected the frequency of overdoses?

Emerg Med Australas

August 2024

Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.

Objectives: In June 2020, modified-release paracetamol (paracetamol-MR) preparations were up-scheduled from schedule-2 (available in pharmacy) to schedule-3 (available by request to a pharmacist only). The present study aims to ascertain whether up-scheduling affected the frequency of paracetamol-MR overdoses.

Methods: This is a retrospective cohort study of two data sets from 1 June 2017 to 31 May 2022.

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Article Synopsis
  • The field of prosthetics has advanced significantly in the last decade, especially in surgical techniques that enhance limb functionality and alleviate neuropathic pain in amputees.
  • Targeted Muscle Reinnervation (TMR) is a key surgical method that reroutes severed nerves to reduce postamputation pain and improve the control of prosthetic limbs, demonstrating effectiveness in preventing painful neuromas.
  • This article outlines the TMR procedure in detail to support an international clinical trial that will assess its efficacy alongside two other surgical techniques for postamputation pain management across nine clinics in seven countries.
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Persistent Critical Illness and Long-Term Outcomes in Patients With COVID-19: A Multicenter Retrospective Cohort Study.

Crit Care Explor

March 2024

Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Objectives: A nontrivial number of patients in ICUs experience persistent critical illness (PerCI), a phenomenon in which features of the ICU course more consistently predict mortality than the initial indication for admission. We aimed to describe PerCI among patients with critical illness caused by COVID-19, and these patients' short- and long-term outcomes.

Design: Multicenter retrospective cohort study.

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FRailty in Australian patients admitted to Intensive care unit after eLective CANCER-related SURGery: a retrospective multicentre cohort study (FRAIL-CANCER-SURG study).

Br J Anaesth

April 2024

Department of Intensive Care, Box Hill Hospital, Eastern Health, Box Hill, VIC, Australia; Department of Intensive Care, Peninsula Health, Frankston, VIC, Australia; Department of Intensive Care, Dandenong Hospital, Dandenong, VIC, Australia; Peninsula Clinical School, Monash University, Frankston, VIC, Australia. Electronic address:

Background: The association between frailty and short-term and long-term outcomes in patients receiving elective surgery for cancer remains unclear, particularly in those admitted to the ICU.

Methods: In this multicentre retrospective cohort study, we included adults ≥16 yr old admitted to 158 ICUs in Australia from January 1, 2018 to March 31, 2022 after elective surgery for cancer. We investigated the association between frailty and survival time up to 4 yr (primary outcome), adjusting for a prespecified set of covariates.

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Rationale: There is significant practice variation in acute paediatric asthma, particularly severe exacerbations. It is unknown whether this is due to differences in clinical guidelines.

Objectives: To describe and compare the content and quality of clinical guidelines for the management of acute exacerbations of asthma in children between geographic regions.

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The impact of body mass index on long-term survival after ICU admission due to COVID-19: A retrospective multicentre study.

Crit Care Resusc

December 2023

Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Objective: The impact of obesity on long-term survival after intensive care unit (ICU) admission with severe coronavirus disease 2019 (COVID-19) is unclear. We aimed to quantify the impact of obesity on time to death up to two years in patients admitted to Australian and New Zealand ICUs.

Design: Retrospective multicentre study.

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Type II myocardial injury following surgical procedures is associated with adverse outcomes. The prognostic value of high-sensitivity cardiac troponin (hs-cTn) due to type II myocardial injury in surgical patients admitted to intensive care unit (ICU) remains unclear. The aim of this study was to assess prognostic value of hs-cTn in type II acute myocardial injury in non-cardiac surgical patients requiring post-operative ICU admission.

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Frailty and long-term survival among patients in Australian intensive care units with metastatic cancer (FRAIL-CANCER study): a retrospective registry-based cohort study.

Lancet Healthy Longev

December 2023

Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Intensive Care, Peninsula Health, Frankston, VIC, Australia; Department of Intensive Care, Dandenong Hospital, Dandenong, VIC, Australia; Peninsula Clinical School, Monash University, Frankston, VIC, Australia.

Background: Recent advances in cancer therapeutics have improved outcomes, resulting in increasing candidacy of patients with metastatic cancer being admitted to intensive care units (ICUs). A large proportion of patients also have frailty, predisposing them to poor outcomes, yet the literature reporting on this is scarce. We aimed to assess the impact of frailty on survival in patients with metastatic cancer admitted to the ICU.

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The impact of integrating bioscience and nursing subjects in a first-year nursing curriculum: A retrospective study.

Nurse Educ Pract

November 2023

School of Nursing and Midwifery, Monash University, McMahons Road, Frankston, Victoria, Australia; Monash Health, Dandenong Hospital, 135 David Street, Dandenong, Victoria, Australia.

Aim: The aim of this study is to explore the effects of integrating bioscience and nursing units on academic achievement and perception in the first-year nursing curriculum.

Background: Nursing students have historically found biosciences difficult and struggle to relate it to nursing practice. In response, nursing and non-nursing academics have employed different teaching modes and integration strategies to enhance learning.

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Objective: To identify the outcomes considered important, and factors influencing the patient experience, for parents and caregivers of children presenting to hospital with a severe acute exacerbation of asthma. This work contributes to the outcome-identification process in developing a core outcome set (COS) for future clinical trials in children with severe acute asthma.

Design: A qualitative study involving semistructured interviews with parents and caregivers of children who presented to hospital with a severe acute exacerbation of asthma.

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