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  • Publication
    Journal Article
    Emergency department assessment and management of children with gastroenteritis.
    (2023-12-31) ;
    Bouchoucha, Stéphane
    ;
    Considine, Julie
    Acute gastroenteritis is a major cause of morbidity and mortality in children. The aim of this study was to explore assessment and management of children aged between 6 and 48 months presenting to the emergency department (ED) with acute gastroenteritis.This retrospective cohort study included 340 children aged 6-48 months. Data were collected by medical record audit for children presenting between 1 January and 31 December 2019.General assessments were appropriate, specific dehydration assessment, blood pressure measurement and fluid balance chart documentation could be improved. Management of children with severe or no/mild dehydration was largely compliant with current recommendations: there was variability in management of children with moderate dehydration. There were no significant differences between Australian Aboriginal and non-Aboriginal children in terms of dehydration severity and pathology abnormalities, however there were differences in management strategies.ED management of children with gastroenteritis was largely consistent with, or superior to, evidence-based recommendations. There was variability in the management of children with moderate dehydration and Australian Aboriginal children but it is unclear whether this is suboptimal or patient specific care. This study has highlighted areas for further research in this unique context.
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  • Person
  • Publication
    Journal Article
    Factors influencing survival and mortality among adult Aboriginal Australians with bronchiectasis-A 10-year retrospective study.
    (2024-05-07) ;
    Gibbs, Claire
    ;
    ;
    Erdenebayar, Davaadorj
    ;
    ;
    Howarth, Timothy
    The prevalence of bronchiectasis among adult Aboriginal Australians is higher than that of non-Aboriginal Australians. However, despite evidence to suggest higher prevalence of bronchiectasis among Aboriginal people in Australia, there is sparce evidence in the literature assessing clinical parameters that may predict survival or mortality in this population.Aboriginal Australians residing in the Top End Health Service region of the Northern Territory of Australia aged >18 years with chest computed tomography (CT) confirmed bronchiectasis between 2011 and 2020 were included. Demographics, body mass index (BMI), medical co-morbidities, lung function data, sputum microbiology, chest CT scan results, hospital admissions restricted to respiratory conditions and all-cause mortality were assessed.A total of 459 patients were included, of whom 146 were recorded deceased (median age at death 59 years). Among the deceased cohort, patients were older (median age 52 vs. 45 years, = 0.023), had a higher prevalence of chronic obstructive pulmonary disease (91 vs. 79%, = 0.126), lower lung function parameters (median percentage predicted forced expiratory volume in 1 s 29 vs. 40%, = 0.149), a significantly greater proportion cultured non- fungi (65 vs. 46%, = 0.007) and (46 vs. 28%, = 0.007) on sputum microbiology and demonstrated bilateral involvement on radiology. In multivariate models advancing age, prior culture and Intensive care unit (ICU) visits were associated with increased odds of mortality. Higher BMI, better lung function on spirometry, prior positive sputum microbiology for and use of inhaled long-acting beta antagonist/muscarinic agents may have a favourable effect.The results of this study may be of use to stratify high risk adult Aboriginal patients with bronchiectasis and to develop strategies to prevent future mortality.
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