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Bankstown Hospital - Grand Rounds - Further Reading

A guide to further information resources to support Grand Rounds and vocational education

Introduction

Welcome to the Grand Rounds Further Reading List, MIcrobiology/AIMS edition, brought to you by the Clinical Library, on Level 4, next to the Auditorium.

This library guide is to help support you in your professional development. Please give us feedback so we can improve this list in the future.

If you have any questions, please contact the Clinical Library on 9722 8250 or email SWSLHD-BankstownLibrary@health.nsw.gov.au or visit us Monday to Fridays, 8.30am - 5.00pm. (closed Wednesday afternoons from 1.00pm to 5.00pm)

Feb 6, 2023

THIS WEEK"S TOPIC

"COVID-19 Burden and Treatment Adherence at Bankstown Hospital: Insights from 2024".

Articles

Burrell, A. J. C., et al. (2021). "Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia." Critical Care and Resuscitation 23(3): 308-319 https://www.sciencedirect.com/science/article/pii/S1441277223004994  FULL TEXT AT LINK

Objective: To report longitudinal differences in baseline characteristics, treatment, and outcomes in patients with coronavirus disease 2019 (COVID-19) admitted to intensive care units (ICUs) between the first and second waves of COVID-19 in Australia. Design, setting and participants: SPRINT-SARI Australia is a multicentre, inception cohort study enrolling adult patients with COVID-19 admitted to participating ICUs. The first wave of COVID-19 was from 27 February to 30 June 2020, and the second wave was from 1 July to 22 October 2020. Results: A total of 461 patients were recruited in 53 ICUs across Australia; a higher number were admitted to the ICU during the second wave compared with the first: 255 (55.3%) versus 206 (44.7%). Patients admitted to the ICU in the second wave were younger (58.0 v 64.0 years; P = 0.001) and less commonly male (68.9% v 60.0%; P = 0.045), although Acute Physiology and Chronic Health Evaluation (APACHE) II scores were similar (14 v 14; P = 0.998). High flow oxygen use (75.2% v 43.4%; P < 0.001) and non-invasive ventilation (16.5% v 7.1%; P = 0.002) were more common in the second wave, as was steroid use (95.0% v 30.3%; P < 0.001). ICU length of stay was shorter (6.0 v 8.4 days; P = 0.003). In-hospital mortality was similar (12.2% v 14.6%; P = 0.452), but observed mortality decreased over time and patients were more likely to be discharged alive earlier in their ICU admission (hazard ratio, 1.43; 95% CI, 1.13–1.79; P = 0.002). Conclusion: During the second wave of COVID-19 in Australia, ICU length of stay and observed mortality decreased over time. Multiple factors were associated with this, including changes in clinical management, the adoption of new evidence-based treatments, and changes in patient demographic characteristics but not illness severity.

Diab, J., et al. (2022). "The patterns and changes of general surgical presentations during the first wave COVID-19 pandemic at a metropolitan Sydney hospital." Research SquareEurope PMC Preprints http://europepmc.org/abstract/PPR/PPR500771

https://www.researchsquare.com/article/rs-1654786/latest.pdf PDF AT LINK

Background; The impact of SARS-COV-2 virus (COVID-19) has been well documented in international settings with a reduction in overall emergency presentations both influenced by social distancing and lockdowns. This study focuses on several common acute general surgical pathologies exploring differences in presentations and clinical outcomes for appendicitis, cholecystitis, and incarcerated hernias during the first wave. Methods:  A retrospective review of medical records of all patients was analysed in two groups: the non-COVID-19 group (combined 2017–2019) and the COVID-19 group (2020). Results: There were 3,316 acute emergency surgical presentations with an 8.2% decrease in total presentations in 2020. There were 477 appendicectomies, 224 cholecystectomies, and 121 repair of incarcerated hernias. All general surgical procedures demonstrated significant differences between non-COVID and COVID cohorts, including length of stay (LoS) (2.7 vs 2.1, p = 0.009) and onset of symptoms (1.6 vs 2.2, p = 0.018) for those aged less than 25 years. Patients with appendicitis aged less than 25 years had a significantly longer onset of symptoms before hospital presentation and shorter LoS in the COVID group (1.7 vs 2.5, p = 0.002; 2.9 vs 2.3, p = 0.016). Likewise, patients with cholecystitis had a significantly longer onset of symptoms in the COVID-19 cohort compared to their counterparts (2.0 vs 3.0 days, p = 0.025). There were no significant differences in biochemical, clinical or post-operative outcomes. Conclusion; The first wave of the COVID-19 pandemic significantly reduced acute general surgical presentations. For those less than 25 years in the COVID-19 cohort, overall LoS was shorter despite indicating significantly delayed presentations.

Govindasamy, L. S., et al. (2021). "Planning for the next pandemic: Reflections on the early phase of the Australian COVID-19 public health response from the emergency department." Emergency Medicine Australasia 33(4): 759-761 https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13799  REQUEST ARTICLE

Abstract: EDs play a crucial role as frontline health services throughout public health emergencies, including pandemics. The strength of the Australian public health response to coronavirus disease 2019 (COVID-19) has mitigated the impact of the pandemic on clinical services, but there has still been a substantial impact on EDs and the health system. We revisit major events and lessons from the first wave of COVID-19 in Australia to consider the implications and avenues for system-level improvements for future pandemic and public health emergency response for EDs. Notwithstanding, the remarkable efforts of healthcare workers across the health system, COVID-19 has uncovered structural and planning challenges and highlighted weaknesses and strengths of the Australian federation. In anticipating future pandemics and other public health threats, particularly in the face of climate change, hard-won lessons from the COVID-19 response should be incorporated in future planning, policies, practice and advocacy.

Scott-King, J., et al. (2022). "The impact of the COVID-19 pandemic on a Sydney metropolitan hospital emergency department." Open Journal of Emergency Medicine 10(4): 183-193 https://www.scirp.org/journal/paperinformation?paperid=121677  FULL TEXT AT LINK.

Abstract

Introduction: The impact of the COVID-19 has resulted in a decrease in presentations in emergency departments (ED). This has been influenced by societal restrictions, lockdowns and access to services. This study aims to observe the patterns in ED presentations for Bankstown-Lidcombe Hospital over the course of the initial COVID-19 pandemic wave. Methods: A retrospective review of all presentations to Bankstown-Lidcombe Hospital ED was conducted comparing monthly patient encounters from February-August for 2017-2020. Results: The total number of ED presentations was 42,225. There was a statistically significant reduction during 2020 of 9.8% between the study periods (1546 vs 1395, p = 0.014). The period of greatest reduction was seen in March-May, the strictest lockdown period for New South Wales. The admitting disciplines that showed a reduction in this time were colorectal (76.62%, p = 0.046), emergency (25.53%, p = 0.025), endocrine (31.82%, p = 0.026), orthopaedics (33.63%, p = 0.004), and vascular (35.71%, p = 0.017). The disciplines that showed an increase in presentations over the entire studied time were gynaecology (26.54%, p = 0.008), and psychiatry (17.46%, p = 0.011). Conclusion: There were significant reductions in total number of ED presentations. Notably, there were significant reductions across multiple admitting disciplines, as well as in a decrease in presentations for those in younger age groups.

Books

E-books