Internal medicine journal
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Internal medicine journal · Nov 2012
Recent trends in Victorian risk-adjusted in-hospital mortality: 1999-2009.
The background of the study is a comparison of risk-adjusted mortality across hospitals from different jurisdictions is now common worldwide. ⋯ Analysis of in-hospital risk-adjusted mortality trends using the HOPE model indicates significant improvement in patient outcomes in the State of Victoria over the past decade.
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Internal medicine journal · Nov 2012
Comparative StudyComparison of recommendations for radiotherapy from two contemporaneous thoracic multidisciplinary meeting formats: co-located and video conference.
Thoracic multidisciplinary meetings (TMDM) are a key component of lung cancer patient management. The optimal design, organisation and function of TMDM are uncertain, and different models may serve different purposes. In the Auckland/Northland region, there are two contemporaneous weekly TMDM using different formats; one is a co-located TMDM (C-TMDM), and the other is a video conference TMDM (V-TMDM) connecting different locations. ⋯ The similar results from the different formats of TMDM indicate that cases discussed with the use of e-health technologies are not disadvantaged with respect to recommended therapy nor in the appropriateness of decisions of the TMDM. Use of such technology may reduce the existing disparities in health outcomes between urban and rural patients.
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The mortality rate post admission to hospital after successful resuscitation from out-of-hospital cardiac arrest is high, with significant variation between regions and individual institutions. While prehospital factors such as age, bystander cardiopulmonary resuscitation and total cardiac arrest time are known to influence outcome, several aspects of post-resuscitative care including therapeutic hypothermia, coronary intervention and goal-directed therapy may also influence patient survival. ⋯ In particular, hospital factors such as hospital size and interventional cardiac care capabilities have been found to influence patient mortality. This paper reviews the evidence supporting the possible development and implementation of Australian cardiac arrest centres.
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Internal medicine journal · Nov 2012
Nutritional status of long-term patients in the acute care setting.
The nutritional status of 926 patients (51.4% female) at an acute tertiary private hospital with a length of stay ≥14 days was assessed using Subjective Global Assessment. The prevalence of malnutrition was 42.5% (37.2% length of stay of 14-27 days, 51.6% ≥28 days). From logistic regression analysis, length of stay and age were independent predictors of malnutrition. It is important that the nutritional status of longer stay patients is monitored and appropriate nutrition support is commenced.