Internal medicine journal
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Internal medicine journal · Sep 2023
Healthcare utilisation and costing for decompensated chronic liver disease hospitalisations at a Victorian network.
The economic burden of decompensated chronic liver disease (CLD) on Australian healthcare services is poorly characterised. ⋯ Hospital admission and readmission for decompensated CLD is common and associated with 40.8% 1-year mortality and high costs. Clearer delineation of goals of care and alternative ambulatory care models for decompensated CLD are urgently required to reduce the high costs and burden on health services.
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Internal medicine journal · Sep 2023
Cerebrospinal fluid neurofilament light and cerebral atrophy in younger-onset dementia and primary psychiatric disorders.
Neurodegeneration underpins the pathological processes of younger-onset dementia (YOD) and has been implicated in primary psychiatric disorders (PSYs). Cerebrospinal fluid (CSF) neurofilament light (NfL) has been used to investigate neurodegeneration severity through correlation with structural brain changes in various conditions, but has seldom been evaluated in YOD and PSYs. ⋯ Higher CSF NfL is related to brain atrophy in YOD, further supporting its use as a nonspecific marker of neurodegeneration severity.
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Internal medicine journal · Sep 2023
Medication use and hospital-acquired acute kidney injury: an electronic health record-based study.
Medications remain an important contributor to the development of acute kidney injury (AKI). This study aimed to examine associations between (i) administration of medications known to reduce glomerular filtration rate (GFR), that is, GFR modifiers and subsequent hospital-acquired AKI; and (ii) potentially medication-related AKI and patient adverse outcomes. ⋯ Administration of medications contributing to the reduction of GFR is associated with an increased risk of hospital-acquired AKI and worse patient outcomes. Caution is required when prescribing these medications to patients at risk of developing AKI, and monitoring patients for deterioration is needed if administered.
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Internal medicine journal · Sep 2023
Stroke Epidemiology and Incidence in Regional Queensland: Findings of the Regional Queensland Stroke (REQUEST) Study.
Stroke rates globally have been declining, but a majority of the studies on strokes have been in urban populations. Regional populations have been understudied, bgeographic health differentials can impact stroke presentations and outcomes. ⋯ Incidence of stroke in a regional Queensland population is similar to other regional populations and when compared with larger cities. Despite a global trend in stroke reduction, modifiable risk factors like hypertension and atrial arrhythmias continue to be over-represented in the stroke population. All-cause mortality after stroke is high, especially during the initial period.
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Internal medicine journal · Sep 2023
Underutilisation of gastric emptying studies and underrecognition of gastroparesis in people with diabetes treated in a hospital setting.
Delayed gastric emptying occurs in up to 30% of patients with long-standing diabetes and causes significant morbidity. We performed a retrospective cohort study of 341 patients who had participated in a gastric emptying study from 2018 to 2021 in a large teaching hospital. Given the expected prevalence of gastroparesis in people with diabetes, there were fewer studies than anticipated, which could lead to gastroparesis underrecognition.