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Background: Survivors of acute kidney injury (AKI) are at increased risk of major adverse kidney events and international guidelines recommend individuals be evaluated 3 months following AKI. Aim: We describe practice patterns and predictors of post‐AKI care in an Australian tertiary hospital. Methods: A retrospective analysis was undertaken of adults with AKI (defined by KDIGO criteria) admitted to a single centre between 2012 and 2016. The primary outcome was outpatient nephrology review at 3 months. Secondary outcomes included inpatient nephrology review, and outpatient serum creatinine and urinary protein measurements. Data were analysed using multivariable logistic and competing risk regression. Results: Only 117 of 2111 (6%) patients with AKI were reviewed by a nephrologist at 3 months. Reviewed patients were more likely to have a higher discharge serum creatinine (odds ratio (OR) 1.20 per 10 μmol/L increase; 95% confidence interval (CI) 1.16–1.25) or a history of peripheral vascular disease (OR 1.77; 95% CI 1.00–3.14). They were less likely to be older (OR 0.66 per decade; 95% CI 0.57–0.76) or to have a history of liver (OR 0.47; 95% CI 0.26–0.87) or ischaemic heart (OR 0.50; 95% CI 0.27–0.94) disease. AKI stage did not predict follow up. The median time from discharge to outpatient serum creatinine testing was 12 days (interquartile range 4–47) and proteinuria was measured in 538 (25%) patients. Conclusions: A minority of admitted AKI patients receive recommended post‐AKI care. Studies in other Australian institutions are required to confirm or refute these concerning findings. [ABSTRACT FROM AUTHOR]

Background: COVID-19 long-term sequelae are ill-defined since only a few studies have explored the long-term consequences of this disease so far. Aims: To evaluate the 6-month respiratory outcome and exercise capacity of COVID-19 acute respiratory failure (ARF) patients treated with continuous positive airway pressure (CPAP) during the first wave of the ongoing COVID-19 pandemic. Methods: A retrospective observational study included COVID-19 patients with ARF. Interventions included CPAP during hospitalisation and 6-month follow up. Frailty assessment was carried out through frailty index (FI), pO2/FiO2 during hospitalisation and at follow up, respiratory parameters, 6-min walking test (6MWT) and the modified British Medical Research Council (mMRC) and Borg scale at follow up. Results: More than half of the patients had no dyspnoea according to the mMRC scale. Lower in-hospital pO2/FiO2 correlated with higher Borg scale levels after 6MWT (- 0.27; P 0.04) at the follow-up visit. FI was positively correlated with length of hospitalisation (- 0.3; P 0.03) and negatively with the 6MWT distance walked (- 0.36; P 0.004). Conclusions: Robust and frail patients with COVID-19 ARF treated with CPAP outside the intensive care unit setting had good respiratory parameters and exercise capacity at 6-month follow up, although more severe patients had slightly poorer respiratory performance compared with patients with higher PaO2/FiO2 and lower FI. [ABSTRACT FROM AUTHOR]

Outpatient services, largely dedicated to routine follow up, have been under increasing pressure in recent years. The growing and ageing UK population has been a large driver of this pressure, requiring a significant increase in annual outpatient appointments. Many of these appointments, however, may be guided by organisational, rather than clinical need, and as a result, some evidence indicates patient attendance rates have fallen, demonstrating a need for more effective, patient‐centred care models. One such model, patient‐initiated follow up (PIFU) has shown significant promise, empowering patients while simultaneously reducing appointment numbers and increasing attendance rates. However, for PIFU to be implemented nationwide several key considerations must be made to ensure patients are appropriately engaged, and supported, in directing their own care. [ABSTRACT FROM AUTHOR]

Background Although there is evidence that minimal surveillance is compatible with an optimal outcome in women after early stage breast cancer, little is known of the surveillance that these women receive. Aims To describe the intended clinical follow up and patterns of use of imaging modalities in low-risk breast cancer survivors who are at least 5 years from diagnosis. Methods Participants in the Bupa Health Foundation Health and Wellbeing After Breast Cancer Study with stage 1 invasive breast cancer at diagnosis, who had survived free of recurrence or new primary breast cancer for at least 5 years, provided information for this analysis. Results The most common choice of physician follow up was with one doctor only (54%). Within this group, the most frequent choice was a general practitioner ( GP) (63%) followed by medical oncologist (23%). Thirty-five per cent of women said that they intended to consult two doctors and within this group, the most common combination was a GP and a medical oncologist (45%). This was despite two out of three women reporting being advised that there was no need to consult a medical oncologist. Over 90% of women reported having a mammogram with, or without, breast ultrasound in the previous 12 months. There was a low rate of use of other imaging tests in the absence of clear indications. Conclusions Minimising unnecessary medical consultations by women with breast cancer at low risk of recurrence 5 years from diagnosis will require education about the benefits of a minimal surveillance strategy. [ABSTRACT FROM AUTHOR]

Background Inferior vena cava ( IVC) filters are increasingly used to treat venous thromboembolism when there are contraindications or failure to respond to anticoagulant therapy. Retrievable filters were introduced to avoid long-term complications and risks associated with permanent filters. However, failure to follow up patients appropriately can lead to low retrieval rates. Aims To examine the practice of our institution in using retrievable IVC filters and to provide a review of published literature. Methods Retrospective audit of medical records in a single medical institution. Results Forty-one patients had retrievable IVC filters inserted. The median age of patients was 67. The majority (78%) of patients had filters inserted for presence of venous thromboembolism and contraindication to anticoagulation. Twenty-five (61%) patients received no clinical follow up. Factors associated with loss to follow up include a lack of documentation for retrieval plan ( P < 0.01), lack of haematology outpatient clinic review ( P < 0.01) and age greater than 50 years ( P < 0.01). Procedural success was achieved in nine of 11 attempted filter removals. Eighteen complications were noted among patients. IVC filter insertion failed to prevent recurrent pulmonary embolisms in three patients. Conclusions Majority of retrievable IVC filters will become lost to clinical follow up. Rates of attempted retrieval within 1 year of filter insertion are low. Loss to follow up is associated with older age, lack of documentation and lack of haematology clinic review post discharge. This study highlights the importance of a structured system to document clearly the review and retrieval plans for patients with IVC filters, at the time of initial insertion. [ABSTRACT FROM AUTHOR]