Abstract:
BACKGROUND:The Northern Territory (NT) has a long history of heavy alcohol consumption with a correspondingly high attributable morbidity and mortality. AIMS:We aimed to describe the number of admissions to Intensive Care associated with alcohol misuse. METHODS:Prospective case-control study including all admissions to NT Intensive Care Units (ICUs) between 1 July 2018 and 30 June 2019. Characteristics and outcomes of patients who had an admission associated with alcohol misuse (a composite measure of acute and/or chronic misuse) were compared to those who did not. Primary outcome was the number of admissions associated with alcohol misuse. Secondary outcomes included measures of resource use (length of stay (LoS), need for mechanical ventilation) and mortality adjusted for illness severity. RESULTS:Over the sampling period there were 1664 admissions. After exclusions, 1471 admissions were analysed, 307 (21%) of which were associated with alcohol misuse. Acute or chronic misuse was associated with 3.7% and 12.1% of admissions respectively, while 5.1% met criteria for both. Admissions associated with alcohol misuse more frequently required ventilation (38.4% vs 20.7%, p<0.01) and had longer ICU (2.8 vs 2.1 days, p<0.01) and hospital LoS (9.1 vs 7.1 days, p<0.01). There was no difference in hospital mortality (7.2% vs 7.7%, p=0.94), even after adjustment for illness severity, hospital and diagnostic category. CONCLUSIONS:Alcohol misuse is associated with a substantial number of critical care admissions and consume considerable acute care resources. Further policy directed at harm minimisation and epidemiological work at jurisdictional and national level is necessary. This article is protected by copyright. All rights reserved.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Secombe P,Campbell L,Brown A,Bailey M,Pilcher Ddoi
10.1111/imj.15212subject
Has Abstractpub_date
2021-01-19 00:00:00eissn
1444-0903issn
1445-5994pub_type
杂志文章abstract::We documented temporal changes in the use of lipid-lowering medications and achievement of cholesterol targets in an Australian diabetes clinic. The number of patients using lipid-lowering therapy for primary or secondary cardiovascular prevention increased from 6 to 69% between 1993-1995 and 2014-2016, which correspo...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13691
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:The reported prevalence of cognitive impairment in patients with stable chronic obstructive pulmonary disease (COPD) ranges 36-77%. Few studies report the prevalence of cognitive impairment in acutely unwell COPD patients. AIMS:To determine the prevalence and time course of cognitive impairment in patients ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14259
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The comparative effectiveness of biologic treatment regimens in a real world Australian population is unknown. AIM:To assess the effectiveness of biological disease-modifying anti-rheumatic drugs (bDMARD) as monotherapy or in combination with methotrexate and/or other conventional DMARD (cDMARD) for the tre...
journal_title:Internal medicine journal
pub_type: 杂志文章,多中心研究
doi:10.1111/imj.14028
更新日期:2018-10-01 00:00:00
abstract::The purpose of this case-control study is to estimate the risks of Stevens-Johnson syndrome or toxic epidermal necrolysis associated with the use of specific drugs. The suspected cases were identified from the computerized hospital discharge file. We calculated crude relative risks and adjusted them for confounding by...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2005.00790.x
更新日期:2005-03-01 00:00:00
abstract::Perhexiline is a prophylactic anti-anginal agent that ameliorates the metabolic basis for myocardial ischaemia and is increasingly used in the management of acute coronary syndromes. No intravenous preparation is available and usual oral loading regimens require 2-3 days to achieve therapeutic drug levels. Two patient...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2004.00624.x
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Increasing numbers of patients receiving new oral anticoagulants (NOAC) are undergoing elective surgery. The extent to which perioperative interruption of NOAC therapy and use of bridging heparin are concordant with best evidence is uncertain. AIMS:To determine: (i) concordance of NOAC and bridging heparin ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13513
更新日期:2017-12-01 00:00:00
abstract::Transfusion-related acute lung injury (TRALI) is a leading cause of transfusion related morbidity and mortality. Current concepts regarding the pathogenesis of this disorder imply a "two-hit" model in which neutrophils are sequestered in the pulmonary capillary bed, and subsequently activated by substances in the tran...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2010.02366.x
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Advance care planning (ACP) provides patients with the ability to make their decisions known about how they would like to be treated if they lose capacity. Medical practitioners have a key role to play in providing information on ACP to their patients. This research explores their knowledge and attitudes to ...
journal_title:Internal medicine journal
pub_type: 杂志文章,随机对照试验
doi:10.1111/imj.12354
更新日期:2014-03-01 00:00:00
abstract::Multiple myeloma is an incurable malignancy of plasma cells. We retrospectively reviewed the survival outcomes of patients with multiple myeloma in Western Australia (WA) public hospitals over a 10-year period. We did not detect a difference in survival between patients residing the metropolitan Perth and regional are...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14905
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Long-term prognosis of acute coronary syndromes (ACS) in human immunodeficiency virus (HIV)-infected patients is unknown. AIMS:To compare outcomes after ACS in HIV-infected and uninfected patients. METHODS:Retrospective observational study. HIV cases were matched with two HIV-uninfected controls for age, s...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14744
更新日期:2020-12-01 00:00:00
abstract::Leprosy remains an important global health concern, but little has been published about its diagnosis and management in developed settings. It has been postulated that delay in diagnosis is common in developed settings. We reviewed all the cases of leprosy seen at a major tertiary referral centre between 1999 and 2013...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/imj.12638
更新日期:2015-01-01 00:00:00
abstract::Over the last 20 years, clinical medicine has witnessed rapid expansion in its underlying evidence base, greater demand for accountability in clinicians' use of limited resources and increasing societal expectation for health care that confers proven benefit at reasonable cost to all eligible recipients. Health servic...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:A number of haematological malignancies can be cured by allogeneic stem cell transplantation but only approximately 30% of Australians have a suitable histocompatible related donor. Matched donors can be found on international registries of unrelated volunteers for a proportion of the remaining patients. For...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2006.01079.x
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Prothrombinex-VF (a three-factor prothrombin complex concentrate) contains little factor VII. Therefore, the Warfarin Reversal Consensus Guidelines from 2004 published by The Australasian Society of Haemostasis and Thrombosis recommend that it be administered with fresh frozen plasma to reverse warfarin anti...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2010.02237.x
更新日期:2011-04-01 00:00:00
abstract::This study aimed to identify the incidence of perioperative acute upper gastrointestinal bleeding (UGIB) in our hip fracture patients; to evaluate the characteristics, management and clinical outcomes of these patients; and to explore risk factors and protective factors. Of the 1691 consecutive patients admitted for s...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13809
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND AND AIM:To identify the underlying heart disease and microbiological pathogen associated with infective endocarditis (IE) in Chinese patients in one university hospital over a 10-year period. METHODS:We recruited 115 adult patients admitted to Peking University First Hospital from 2002 to 2011 who were diag...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.12248
更新日期:2013-12-01 00:00:00
abstract::More than 177 000 potentially preventable healthcare-associated infections (HAIs) occur per annum in Australia with sizable attributable mortality. Organizational systems to protect against HAI in hospitals in Australia are relatively poorly developed. Awareness and practice of infection control by medical and other h...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2009.02004.x
更新日期:2009-09-01 00:00:00
abstract:AIMS:Our primary aim was to determine the rate of overseas travel in immunocompromised individuals attending appropriate clinics at an Australian tertiary care hospital. We also aimed to characterise health-seeking behaviour prior to travel and investigated sources of pre-travel advice, compared travel patterns and act...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.12753
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The effects of empagliflozin on cardiac structure and function are not known. AIMS:To examine the changes in cardiac structure and function following the addition of empagliflozin in patients with type 2 (T2D) diabetes using cardiac magnetic resonance (CMR) imaging. METHODS:Twenty patients attending a spec...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14260
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The short Synacthen test is widely used to assess the hypothalamus pituitary adrenal axis in the outpatient setting. In the inpatient setting however, technical difficulties to adhere to the protocol may pose a challenge for using this test. AIMS:In this study we attempted to find the most suitable basal se...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.15033
更新日期:2020-08-24 00:00:00
abstract:BACKGROUND:Teaching, mentoring and supervision (TMS) are fundamental skills with a specific commitment within the Royal Australasian College of Physicians (RACP) professional practice framework. The new basic training standards include 'use of appropriate educational techniques to facilitate the learning of peers, juni...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14935
更新日期:2020-06-08 00:00:00
abstract::The burden and consequences of skin infections for remote living indigenous people are high. While skin infections are recognised as an antecedent to conditions such as acute rheumatic fever in children, data are limited concerning skin infection complications such as cellulitis, abscesses and osteomyelitis in older c...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14858
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Lung cancer accounts for significant morbidity and mortality worldwide. The effect of recent changes in demographics and management on outcomes in Australia has not been clearly defined. AIMS:To compare three consecutive lung cancer cohorts to evaluate emergent differences in diagnosis, management and morta...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13132
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Tuberculous lymphadenitis is the commonest form of extrapulmonary tuberculosis. However, the optimal approach to diagnosis, employing biopsy by either fine needle aspiration (FNA) or surgical excision, remains uncertain. AIMS:To evaluate the diagnostic value of biopsy using each of the component diagnostic ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2012.02748.x
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Patients with established coronary heart disease (CHD) are at the highest risk of further events. Despite proven therapies, secondary prevention is often suboptimal. General practitioners (GPs) are in an ideal position to improve secondary prevention. AIM:To contrast management of cardiovascular risk factor...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2011.02534.x
更新日期:2011-10-01 00:00:00
abstract::This paper uses a case example to review the current legal status of advance directives, as well as their ethical rationale. We draw attention to ongoing efforts to institutionalize advance directives, and to some of the tractable and intractable reasons why advance directives are ineffective. We then introduce the co...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2005.00915.x
更新日期:2005-09-01 00:00:00
abstract:AIMS:The aim of this study was to provide the first population-based descriptions of typical sleep duration and the prevalence of chronic sleep restriction and chronic sleepiness in community-dwelling Australian adults. METHODS:Ten thousand subjects randomly selected from the New South Wales electoral roll, half aged ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2007.01395.x
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:There are no sufficient data available on the use of febuxostat in patients undergoing dialysis. AIM:We investigated the efficacy and tolerability of febuxostat in gout patients on dialysis. METHODS:We retrospectively reviewed clinical and laboratory data available from a referral center from January 2012 ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14776
更新日期:2020-02-11 00:00:00
abstract:BACKGROUND:Many patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have type 2 respiratory failure (T2RF). Often arterial blood gases are not performed and correlation with venous blood gases (VBG) is controversial. The venous pH and bicarbonate (HCO3 ) are useful, but VBG pCO2 (PvCO2 )...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14186
更新日期:2019-07-01 00:00:00
abstract::This paper examines the differences between clinical and public health ethics and provides several examples of contemporary public health challenges that pose ethical questions. The relations among ethics, rights and obligations are explored, because public health philosophers propose these as different ways for publi...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2004.00643.x
更新日期:2004-07-01 00:00:00