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33 results on '"Bohensky, M. A."'

6. Protocol for a multi-centre randomised controlled trial comparing arthroscopic hip surgery to physiotherapy-led care for femoroacetabular impingement (FAI): the Australian FASHIoN trial

Author

Murphy, NJ, Eyles, J, Bennell, KL, Bohensky, M, Burns, A, Callaghan, FM, Dickenson, E, Fary, C, Grieve, SM, Griffin, DR, Hall, M, Hobson, R, Kim, YJ, Linklater, JM, Lloyd, DG, Molnar, R, O'Connell, RL, O'Donnell, J, O'Sullivan, M, Randhawa, S, Reichenbach, S, Saxby, DJ, Singh, P, Spiers, L, Phong, T, Wrigley, TV, Hunter, DJ, Murphy, NJ, Eyles, J, Bennell, KL, Bohensky, M, Burns, A, Callaghan, FM, Dickenson, E, Fary, C, Grieve, SM, Griffin, DR, Hall, M, Hobson, R, Kim, YJ, Linklater, JM, Lloyd, DG, Molnar, R, O'Connell, RL, O'Donnell, J, O'Sullivan, M, Randhawa, S, Reichenbach, S, Saxby, DJ, Singh, P, Spiers, L, Phong, T, Wrigley, TV, and Hunter, DJ

Abstract

BACKGROUND: Femoroacetabular impingement syndrome (FAI), a hip disorder affecting active young adults, is believed to be a leading cause of hip osteoarthritis (OA). Current management approaches for FAI include arthroscopic hip surgery and physiotherapy-led non-surgical care; however, there is a paucity of clinical trial evidence comparing these approaches. In particular, it is unknown whether these management approaches modify the future risk of developing hip OA. The primary objective of this randomised controlled trial is to determine if participants with FAI who undergo hip arthroscopy have greater improvements in hip cartilage health, as demonstrated by changes in delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) index between baseline and 12 months, compared to those who undergo physiotherapy-led non-surgical management. METHODS: This is a pragmatic, multi-centre, two-arm superiority randomised controlled trial comparing hip arthroscopy to physiotherapy-led management for FAI. A total of 140 participants with FAI will be recruited from the clinics of participating orthopaedic surgeons, and randomly allocated to receive either surgery or physiotherapy-led non-surgical care. The surgical intervention involves arthroscopic FAI surgery from one of eight orthopaedic surgeons specialising in this field, located in three different Australian cities. The physiotherapy-led non-surgical management is an individualised physiotherapy program, named Personalised Hip Therapy (PHT), developed by a panel to represent the best non-operative care for FAI. It entails at least six individual physiotherapy sessions over 12 weeks, and up to ten sessions over six months, provided by experienced musculoskeletal physiotherapists trained to deliver the PHT program. The primary outcome measure is the change in dGEMRIC score of a ROI containing both acetabular and femoral head cartilages at the chondrolabral transitional zone of the mid-sagittal plane be

Published
2017

7. Myocardial infarction and mortality following joint surgery in patients with rheumatoid arthritis: a retrospective cohort study

Author

Tropea, J, Brand, CA, Bohensky, M, Van Doornum, S, Tropea, J, Brand, CA, Bohensky, M, and Van Doornum, S

Abstract

BACKGROUND: Rheumatoid arthritis (RA) is associated with an increased risk of myocardial infarction (MI) and post-MI fatality compared with the general population. In a previous study examining post-MI treatment in RA compared with controls we noted that a higher proportion of the RA patients had experienced MI following a surgical procedure. The aim of this study was to compare the risk of MI and mortality at 6 weeks and 12 months following joint surgery in patients with RA compared with the general population. METHODS: Individuals who had undergone joint surgery in Victoria, Australia between 1 July 2000 and 30 June 2007 were identified from routinely collected hospital administrative data. Logistic regression analysis was performed to examine odds of 6 week and 12 month MI and mortality in RA versus non-RA patients with adjustment for age, sex, comorbidities, socioeconomic status, patient type and admission type. Subgroup analysis of total hip and knee arthroplasty episodes was undertaken. RESULTS: A total of 308,589 episodes of joint surgery occurred among 240,571 individuals, with 3654 (1.2 %) occurring among patients with RA. At 6 weeks post joint surgery the adjusted odds ratio (OR) for MI was 1.50 (95 % CI 0.96-2.33), all-cause death was 1.85 (95 % CI 1.09-3.13) and cardiovascular death was 1.90 (95 % CI 1.07-3.37). At 12 months post joint surgery the adjusted OR of MI was 1.70 (95 % CI 1.27-2.28), all-cause death was 2.18 (95 % CI 1.66-2.86) and cardiovascular death was 2.30 (95 % CI 1.65-3.22). On analysis of joint surgeries other than hip or knee arthroplasty, people with RA were at greater risk of MI within 6 weeks (adjusted OR 2.32; 95 % CI 1.24-4.34) and 12 months (adjusted OR 2.20; 95 % CI 1.47-3.30) compared to those without RA, but no difference in odds of short term mortality were found. CONCLUSIONS: Following an episode of joint surgery RA patients have a significantly increased risk of death at 6 weeks, and MI and death at 12 months, compared to

Published
2016

8. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Wang, H., Naghavi, M., Allen, C., Barber, R., Bhutta, Z., Carter, A., Casey, D., Charlson, F., Chen, A., Coates, M., Coggeshall, M., Dandona, L., Dicker, D., Erskine, H., Ferrari, A., Fitzmaurice, C., Foreman, K., Forouzanfar, M., Fraser, M., Pullman, N., Gething, P., Goldberg, E., Graetz, N., Haagsma, J., Hay, S., Huynh, C., Johnson, C., Kassebaum, N., Kinfu, Y., Kulikoff, X., Kutz, M., Kyu, H., Larson, H., Leung, J., Liang, X., Lim, S., Lind, M., Lozano, R., Marquez, N., Mensah, G., Mikesell, J., Mokdad, A., Mooney, M., Nguyen, G., Nsoesie, E., Pigott, D., Pinho, C., Roth, G., Salomon, J., Sandar, L., Silpakit, N., Sligar, A., Sorensen, R., Stanaway, J., Steiner, C., Teeple, S., Thomas, B., Troeger, C., VanderZanden, A., Vollset, S., Wanga, V., Whiteford, H., Wolock, T., Zoeckler, L., Abate, K., Abbafati, C., Abbas, K., Abd-Allah, F., Abera, S., Abreu, D., Abu-Raddad, L., Abyu, G., Achoki, T., Adelekan, A., Ademi, Z., Adou, A., Adsuar, J., Afanvi, K., Afshin, A., Agardh, E., Agarwal, A., Agrawal, A., Kiadaliri, A., Ajala, O., Akanda, A., Akinyemi, R., Akinyemiju, T., Akseer, N., Al Lami, F., Alabed, S., Al-Aly, Z., Alam, K., Alam, N., Alasfoor, D., Aldhahri, S., Aldridge, R., Alegretti, M., Aleman, A., Alemu, Z., Alexander, L., Alhabib, S., Ali, R., Alkerwi, A., Alla, F., Allebeck, P., Al-Raddadi, R., Alsharif, U., Altirkawi, K., Martin, E., Alvis-Guzman, N., Amare, A., Amegah, A., Ameh, E., Amini, H., Ammar, W., Amrock, S., Andersen, H., Anderson, B., Anderson, G., Antonio, C., Aregay, A., Arnlov, J., Arsenijevic, V., Al, A., Asayesh, H., Asghar, R., Atique, S., Arthur Avokpaho, E., Awasthi, A., Azzopardi, P., Bacha, U., Badawi, A., Bahit, M., Balakrishnan, K., Banerjee, A., Barac, A., Barker-Collo, S., Barnighausen, T., Barregard, L., Barrero, L., Basu, A., Basu, S., Bayou, Y., Bazargan-Hejazi, S., Beardsley, J., Bedi, N., Beghi, E., Belay, H., Bell, B., Bell, M., Bello, A., Bennett, D., Bensenor, I., Berhane, A., Bernabe, E., Betsu, B., Beyene, A., Bhala, N., Bhalla, A., Biadgilign, S., Bikbov, B., Bin Abdulhak, A., Biroscak, B., Biryukov, S., Bjertness, E., Blore, J., Blosser, C., Bohensky, M., Borschmann, R., Bose, D., Bourne, R., Brainin, M., Brayne, C., Brazinova, A., Breitborde, N., Brenner, H., Brewer, J., Brown, A., Brown, J., Brugha, T., Buckle, G., Butt, Z., Calabria, B., Campos-Novato, I., Campuzano, J., Carapetis, J., Cardenas, R., Carpenter, D., Carrero, J., Castaneda-Oquela, C., Rivas, J., Catala-Lopez, F., Cavalleri, F., Cercy, K., Cerda, J., Chen, W., Chew, A., Chiang, P., Chibalabala, M., Chibueze, C., Chimed-Ochir, O., Chisumpa, V., Choi, J., Chowdhury, R., Christensen, H., Christopher, D., Ciobanu, L., Cirillo, M., Cohen, A., Colistro, V., Colomar, M., Colquhoun, S., Cooper, C., Cooper, L., Cortinovis, M., Cowie, B., Crump, J., Damsere-Derry, J., Danawi, H., Dandona, R., Daoud, F., Darby, S., Dargan, P., das Neves, J., Davey, G., Davis, A., Davitoiu, D., de Castro, E., de Jager, P., De Leo, D., Degenhardt, L., Dellavalle, R., Deribe, K., Deribew, A., Dharmaratne, S., Dhillon, P., Diaz-Torne, C., Ding, E., dos Santos, K., Dossou, E., Driscoll, T., Duan, L., Dubey, M., Bartholow, B., Ellenbogen, R., Lycke, C., Elyazar, I., Endries, A., Ermakov, S., Eshrati, B., Esteghamati, A., Estep, K., Faghmous, I., Fahimi, S., Jose, E., Farid, T., Sa Farinha, C., Faro, A., Farvid, M., Farzadfar, F., Feigin, V., Fereshtehnejad, S., Fernandes, J., Fischer, F., Fitchett, J., Flaxman, A., Foigt, N., Fowkes, F., Franca, E., Franklin, R., Friedman, J., Frostad, J., Hirst, T., Futran, N., Gall, S., Gambashidze, K., Gamkrelidze, A., Ganguly, P., Gankpe, F., Gebre, T., Gebrehiwot, T., Gebremedhin, A., Gebru, A., Geleijnse, J., Gessner, B., Ghoshal, A., Gibney, K., Gillum, R., Gilmour, S., Giref, A., Giroud, M., Gishu, M., Giussani, G., Glaser, E., Godwin, W., Gomez-Dantes, H., Gona, P., Goodridge, A., Gopalani, S., Gosselin, R., Gotay, C., Goto, A., Gouda, H., Greaves, F., Gugnani, H., Gupta, R., Gupta, V., Gutierrez, R., Hafezi-Nejad, N., Haile, D., Hailu, A., Hailu, G., Halasa, Y., Hamadeh, R., Hamidi, S., Hancock, J., Handal, A., Hankey, G., Hao, Y., Harb, H., Harikrishnan, S., Haro, J., Havmoeller, R., Heckbert, S., Heredia-Pi, I., Heydarpour, P., Hilderink, H., Hoek, H., Hogg, R., Horino, M., Horita, N., Hosgood, H., Hotez, P., Hoy, D., Hsairi, M., Htet, A., Than Htike, M., Hu, G., Huang, C., Huang, H., Huiart, L., Husseini, A., Huybrechts, I., Huynh, G., Iburg, K., Innos, K., Inoue, M., Iyer, V., Jacobs, T., Jacobsen, K., Jahanmehr, N., Jakovljevic, M., James, P., Javanbakht, M., Jayaraman, S., Jayatilleke, A., Jeemon, P., Jensen, P., Jha, V., Jiang, G., Jiang, Y., Jibat, T., Jimenez-Corona, A., Jonas, J., Joshi, T., Kabir, Z., Karnak, R., Kan, H., Kant, S., Karch, A., Karema, C., Karimkhani, C., Karletsos, D., Karthikeyan, G., Kasaeian, A., Katibeh, M., Kaul, A., Kawakami, N., Kayibanda, J., Keiyoro, P., Kemmer, L., Kemp, A., Kengne, A., Keren, A., Kereselidze, M., Kesavachandran, C., Khader, Y., Khalil, I., Khan, A., Khan, E., Khang, Y., Khera, S., Muthafer Khoja, T., Kieling, C., Kim, D., Kim, Y., Kissela, B., Kissoon, N., Knibbs, L., Knudsen, A., Kokubo, Y., Kolte, D., Kopec, J., Kosen, S., Koul, P., Koyanagi, A., Krog, N., Defo, B., Bicer, B., Kudom, A., Kuipers, E., Kulkarni, V., Kumar, G., Kwan, G., Lal, A., Lal, D., Lalloo, R., Lam, H., Lam, J., Langan, S., Lansingh, V., Larsson, A., Laryea, D., Latif, A., Lawrynowicz, A., Leigh, J., Levi, M., Li, Y., Lindsay, M., Lipshultz, S., Liu, P., Liu, S., Liu, Y., Lo, L., Logroscino, G., Lotufo, P., Lucas, R., Lunevicius, R., Lyons, R., Ma, S., Pedro Machado, V., Mackay, M., MacLachlan, J., Abd El Razek, H., Abd El Razek, M., Majdan, M., Majeed, A., Malekzadeh, R., Ayele Manamo, W., Mandisarisa, J., Mangalam, S., Mapoma, C., Marcenes, W., Margolis, D., Martin, G., Martinez-Raga, J., Marzan, M., Masiye, F., Mason-Jones, A., Massano, J., Matzopoulos, R., Mayosi, B., McGarvey, S., McGrath, J., Mckee, M., McMahon, B., Meaney, P., Mehari, A., Mehndiratta, M., Mena-Rodriguez, F., Mekonnen, A., Melaku, Y., Memiah, P., Memish, Z., Mendoza, W., Meretoja, A., Meretoja, T., Mhimbira, F., Micha, R., Miller, Ted, Mirarefin, M., Misganaw, A., Mock, C., Abdulmuhsin Mohammad, K., Mohammadi, A., Mohammed, S., Mohan, V., Mola, G., Monasta, L., Montanez Hernandez, J., Montero, P., Montico, M., Montine, T., Moradi-Lakeh, M., Morawska, L., Morgan, K., Mori, R., Mozaffarian, D., Mueller, U., Satyanarayana Murthy, G., Murthy, S., Musa, K., Nachega, J., Nagel, G., Naidoo, K., Naik, N., Naldi, L., Nangia, V., Nash, D., Nejjari, C., Neupane, S., Newton, C., Newton, J., Ng, M., Ngalesoni, F., Ngirabega, J., Quyen, L., Nisar, M., Nkamedjie Pete, P., Nomura, M., Norheim, O., Norman, P., Norrving, B., Nyakarahuka, L., Ogbo, F., Ohkubo, T., Ojelabi, F., Olivares, P., Olusanya, B., Olusanya, J., Opio, J., Oren, E., Ortiz, A., Osman, M., Ota, E., Ozdemir, R., Pa, M., Pandian, J., Pant, P., Papachristou, C., Park, E., Park, J., Parry, C., Parsaeian, M., Caicedo, A., Patten, S., Patton, G., Paul, V., Pearce, N., Pedro, J., Stokic, L., Pereira, D., Perico, N., Pesudovs, K., Petzold, M., Phillips, M., Piel, F., Pillay, J., Plass, D., Platts-Mills, J., Polinder, S., Pope, C., Popova, S., Poulton, R., Pourmalek, F., Prabhakaran, D., Qorbani, M., Quame-Amaglo, J., Quistberg, D., Rafay, A., Rahimi, K., Rahimi-Movaghar, V., Rahman, M., Rahman, S., Rai, R., Rajavi, Z., Rajsic, S., Raju, M., Rakovac, I., Rana, S., Ranabhat, C., Rangaswamy, T., Rao, P., Rao, S., Refaat, A., Rehm, J., Reitsma, M., Remuzzi, G., Resnikofff, S., Ribeiro, A., Ricci, S., Blancas, M., Roberts, B., Roca, A., Rojas-Rueda, D., Ronfani, L., Roshandel, G., Rothenbacher, D., Roy, A., Roy, N., Ruhago, G., Sagar, R., Saha, S., Sahathevan, R., Saleh, M., Sanabria, J., Sanchez-Nino, M., Sanchez-Riera, L., Santos, I., Sarmiento-Suarez, R., Sartorius, B., Satpathy, M., Savic, M., Sawhney, M., Schaub, M., Schmidt, M., Schneider, I., Schottker, B., Schutte, A., Schwebel, D., Seedat, S., Sepanlou, S., Servan-Mori, E., Shackelford, K., Shaddick, G., Shaheen, A., Shahraz, S., Shaikh, M., Shakh-Nazarova, M., Sharma, R., She, J., Sheikhbahaei, S., Shen, J., Shen, Z., Shepard, D., Sheth, K., Shetty, B., Shi, P., Shibuya, K., Shin, M., Shiri, R., Shiue, I., Shrime, M., Sigfusdottir, I., Silberberg, D., Silva, D., Silveira, D., Silverberg, J., Simard, E., Singh, A., Singh, G., Singh, J., Singh, O., Singh, P., Singh, V., Soneji, S., Soreide, K., Soriano, J., Sposato, L., Sreeramareddy, C., Stathopoulou, V., Stein, D., Stein, M., Stranges, S., Stroumpoulis, K., Sunguya, B., Sur, P., Swaminathan, S., Sykes, B., Szoeke, C., Tabares-Seisdedos, R., Tabb, K., Takahashi, K., Takala, J., Talongwa, R., Tandon, N., Tavakkoli, M., Taye, B., Taylor, H., Ao, B., Tedla, B., Tefera, W., Ten Have, M., Terkawi, A., Tesfay, F., Tessema, G., Thomson, A., Thorne-Lyman, A., Thrift, A., Thurston, G., Tillmann, T., Tirschwell, D., Tonelli, M., Topor-Madry, R., Topouzis, F., Nx, J., Traebert, J., Tran, B., Truelsen, T., Trujillo, U., Tura, A., Tuzcu, E., Uchendu, U., Ukwaja, K., Undurraga, E., Uthman, O., Van Dingenen, R., Van Donkelaar, A., Vasankari, T., Vasconcelos, A., Venketasubramanian, N., Vidavalur, R., Vijayakumar, L., Villalpando, S., Violante, F., Vlassov, V., Wagner, J., Wagner, G., Wallin, M., Wang, L., Watkins, D., Weichenthal, S., Weiderpass, E., Weintraub, R., Werdecker, A., Westerman, R., White, R., Wijeratne, T., Wilkinson, J., Williams, H., Wiysonge, C., Woldeyohannes, S., Wolfe, C., Won, S., Wong, J., Woolf, A., Xavier, D., Xiao, Q., Xu, G., Yakob, B., Yalew, A., Yan, L., Yano, Y., Yaseri, M., Ye, P., Yebyo, H., Yip, P., Yirsaw, B., Yonemoto, N., Yonga, G., Younis, M., Yu, S., Zaidi, Z., Zaki, M., Zannad, F., Zavala, D., Zeeb, H., Zeleke, B., Zhang, H., Zodpey, S., Zonies, D., Zuhlke, L., Vos, T., Lopez, A., Murray, C., Wang, H., Naghavi, M., Allen, C., Barber, R., Bhutta, Z., Carter, A., Casey, D., Charlson, F., Chen, A., Coates, M., Coggeshall, M., Dandona, L., Dicker, D., Erskine, H., Ferrari, A., Fitzmaurice, C., Foreman, K., Forouzanfar, M., Fraser, M., Pullman, N., Gething, P., Goldberg, E., Graetz, N., Haagsma, J., Hay, S., Huynh, C., Johnson, C., Kassebaum, N., Kinfu, Y., Kulikoff, X., Kutz, M., Kyu, H., Larson, H., Leung, J., Liang, X., Lim, S., Lind, M., Lozano, R., Marquez, N., Mensah, G., Mikesell, J., Mokdad, A., Mooney, M., Nguyen, G., Nsoesie, E., Pigott, D., Pinho, C., Roth, G., Salomon, J., Sandar, L., Silpakit, N., Sligar, A., Sorensen, R., Stanaway, J., Steiner, C., Teeple, S., Thomas, B., Troeger, C., VanderZanden, A., Vollset, S., Wanga, V., Whiteford, H., Wolock, T., Zoeckler, L., Abate, K., Abbafati, C., Abbas, K., Abd-Allah, F., Abera, S., Abreu, D., Abu-Raddad, L., Abyu, G., Achoki, T., Adelekan, A., Ademi, Z., Adou, A., Adsuar, J., Afanvi, K., Afshin, A., Agardh, E., Agarwal, A., Agrawal, A., Kiadaliri, A., Ajala, O., Akanda, A., Akinyemi, R., Akinyemiju, T., Akseer, N., Al Lami, F., Alabed, S., Al-Aly, Z., Alam, K., Alam, N., Alasfoor, D., Aldhahri, S., Aldridge, R., Alegretti, M., Aleman, A., Alemu, Z., Alexander, L., Alhabib, S., Ali, R., Alkerwi, A., Alla, F., Allebeck, P., Al-Raddadi, R., Alsharif, U., Altirkawi, K., Martin, E., Alvis-Guzman, N., Amare, A., Amegah, A., Ameh, E., Amini, H., Ammar, W., Amrock, S., Andersen, H., Anderson, B., Anderson, G., Antonio, C., Aregay, A., Arnlov, J., Arsenijevic, V., Al, A., Asayesh, H., Asghar, R., Atique, S., Arthur Avokpaho, E., Awasthi, A., Azzopardi, P., Bacha, U., Badawi, A., Bahit, M., Balakrishnan, K., Banerjee, A., Barac, A., Barker-Collo, S., Barnighausen, T., Barregard, L., Barrero, L., Basu, A., Basu, S., Bayou, Y., Bazargan-Hejazi, S., Beardsley, J., Bedi, N., Beghi, E., Belay, H., Bell, B., Bell, M., Bello, A., Bennett, D., Bensenor, I., Berhane, A., Bernabe, E., Betsu, B., Beyene, A., Bhala, N., Bhalla, A., Biadgilign, S., Bikbov, B., Bin Abdulhak, A., Biroscak, B., Biryukov, S., Bjertness, E., Blore, J., Blosser, C., Bohensky, M., Borschmann, R., Bose, D., Bourne, R., Brainin, M., Brayne, C., Brazinova, A., Breitborde, N., Brenner, H., Brewer, J., Brown, A., Brown, J., Brugha, T., Buckle, G., Butt, Z., Calabria, B., Campos-Novato, I., Campuzano, J., Carapetis, J., Cardenas, R., Carpenter, D., Carrero, J., Castaneda-Oquela, C., Rivas, J., Catala-Lopez, F., Cavalleri, F., Cercy, K., Cerda, J., Chen, W., Chew, A., Chiang, P., Chibalabala, M., Chibueze, C., Chimed-Ochir, O., Chisumpa, V., Choi, J., Chowdhury, R., Christensen, H., Christopher, D., Ciobanu, L., Cirillo, M., Cohen, A., Colistro, V., Colomar, M., Colquhoun, S., Cooper, C., Cooper, L., Cortinovis, M., Cowie, B., Crump, J., Damsere-Derry, J., Danawi, H., Dandona, R., Daoud, F., Darby, S., Dargan, P., das Neves, J., Davey, G., Davis, A., Davitoiu, D., de Castro, E., de Jager, P., De Leo, D., Degenhardt, L., Dellavalle, R., Deribe, K., Deribew, A., Dharmaratne, S., Dhillon, P., Diaz-Torne, C., Ding, E., dos Santos, K., Dossou, E., Driscoll, T., Duan, L., Dubey, M., Bartholow, B., Ellenbogen, R., Lycke, C., Elyazar, I., Endries, A., Ermakov, S., Eshrati, B., Esteghamati, A., Estep, K., Faghmous, I., Fahimi, S., Jose, E., Farid, T., Sa Farinha, C., Faro, A., Farvid, M., Farzadfar, F., Feigin, V., Fereshtehnejad, S., Fernandes, J., Fischer, F., Fitchett, J., Flaxman, A., Foigt, N., Fowkes, F., Franca, E., Franklin, R., Friedman, J., Frostad, J., Hirst, T., Futran, N., Gall, S., Gambashidze, K., Gamkrelidze, A., Ganguly, P., Gankpe, F., Gebre, T., Gebrehiwot, T., Gebremedhin, A., Gebru, A., Geleijnse, J., Gessner, B., Ghoshal, A., Gibney, K., Gillum, R., Gilmour, S., Giref, A., Giroud, M., Gishu, M., Giussani, G., Glaser, E., Godwin, W., Gomez-Dantes, H., Gona, P., Goodridge, A., Gopalani, S., Gosselin, R., Gotay, C., Goto, A., Gouda, H., Greaves, F., Gugnani, H., Gupta, R., Gupta, V., Gutierrez, R., Hafezi-Nejad, N., Haile, D., Hailu, A., Hailu, G., Halasa, Y., Hamadeh, R., Hamidi, S., Hancock, J., Handal, A., Hankey, G., Hao, Y., Harb, H., Harikrishnan, S., Haro, J., Havmoeller, R., Heckbert, S., Heredia-Pi, I., Heydarpour, P., Hilderink, H., Hoek, H., Hogg, R., Horino, M., Horita, N., Hosgood, H., Hotez, P., Hoy, D., Hsairi, M., Htet, A., Than Htike, M., Hu, G., Huang, C., Huang, H., Huiart, L., Husseini, A., Huybrechts, I., Huynh, G., Iburg, K., Innos, K., Inoue, M., Iyer, V., Jacobs, T., Jacobsen, K., Jahanmehr, N., Jakovljevic, M., James, P., Javanbakht, M., Jayaraman, S., Jayatilleke, A., Jeemon, P., Jensen, P., Jha, V., Jiang, G., Jiang, Y., Jibat, T., Jimenez-Corona, A., Jonas, J., Joshi, T., Kabir, Z., Karnak, R., Kan, H., Kant, S., Karch, A., Karema, C., Karimkhani, C., Karletsos, D., Karthikeyan, G., Kasaeian, A., Katibeh, M., Kaul, A., Kawakami, N., Kayibanda, J., Keiyoro, P., Kemmer, L., Kemp, A., Kengne, A., Keren, A., Kereselidze, M., Kesavachandran, C., Khader, Y., Khalil, I., Khan, A., Khan, E., Khang, Y., Khera, S., Muthafer Khoja, T., Kieling, C., Kim, D., Kim, Y., Kissela, B., Kissoon, N., Knibbs, L., Knudsen, A., Kokubo, Y., Kolte, D., Kopec, J., Kosen, S., Koul, P., Koyanagi, A., Krog, N., Defo, B., Bicer, B., Kudom, A., Kuipers, E., Kulkarni, V., Kumar, G., Kwan, G., Lal, A., Lal, D., Lalloo, R., Lam, H., Lam, J., Langan, S., Lansingh, V., Larsson, A., Laryea, D., Latif, A., Lawrynowicz, A., Leigh, J., Levi, M., Li, Y., Lindsay, M., Lipshultz, S., Liu, P., Liu, S., Liu, Y., Lo, L., Logroscino, G., Lotufo, P., Lucas, R., Lunevicius, R., Lyons, R., Ma, S., Pedro Machado, V., Mackay, M., MacLachlan, J., Abd El Razek, H., Abd El Razek, M., Majdan, M., Majeed, A., Malekzadeh, R., Ayele Manamo, W., Mandisarisa, J., Mangalam, S., Mapoma, C., Marcenes, W., Margolis, D., Martin, G., Martinez-Raga, J., Marzan, M., Masiye, F., Mason-Jones, A., Massano, J., Matzopoulos, R., Mayosi, B., McGarvey, S., McGrath, J., Mckee, M., McMahon, B., Meaney, P., Mehari, A., Mehndiratta, M., Mena-Rodriguez, F., Mekonnen, A., Melaku, Y., Memiah, P., Memish, Z., Mendoza, W., Meretoja, A., Meretoja, T., Mhimbira, F., Micha, R., Miller, Ted, Mirarefin, M., Misganaw, A., Mock, C., Abdulmuhsin Mohammad, K., Mohammadi, A., Mohammed, S., Mohan, V., Mola, G., Monasta, L., Montanez Hernandez, J., Montero, P., Montico, M., Montine, T., Moradi-Lakeh, M., Morawska, L., Morgan, K., Mori, R., Mozaffarian, D., Mueller, U., Satyanarayana Murthy, G., Murthy, S., Musa, K., Nachega, J., Nagel, G., Naidoo, K., Naik, N., Naldi, L., Nangia, V., Nash, D., Nejjari, C., Neupane, S., Newton, C., Newton, J., Ng, M., Ngalesoni, F., Ngirabega, J., Quyen, L., Nisar, M., Nkamedjie Pete, P., Nomura, M., Norheim, O., Norman, P., Norrving, B., Nyakarahuka, L., Ogbo, F., Ohkubo, T., Ojelabi, F., Olivares, P., Olusanya, B., Olusanya, J., Opio, J., Oren, E., Ortiz, A., Osman, M., Ota, E., Ozdemir, R., Pa, M., Pandian, J., Pant, P., Papachristou, C., Park, E., Park, J., Parry, C., Parsaeian, M., Caicedo, A., Patten, S., Patton, G., Paul, V., Pearce, N., Pedro, J., Stokic, L., Pereira, D., Perico, N., Pesudovs, K., Petzold, M., Phillips, M., Piel, F., Pillay, J., Plass, D., Platts-Mills, J., Polinder, S., Pope, C., Popova, S., Poulton, R., Pourmalek, F., Prabhakaran, D., Qorbani, M., Quame-Amaglo, J., Quistberg, D., Rafay, A., Rahimi, K., Rahimi-Movaghar, V., Rahman, M., Rahman, S., Rai, R., Rajavi, Z., Rajsic, S., Raju, M., Rakovac, I., Rana, S., Ranabhat, C., Rangaswamy, T., Rao, P., Rao, S., Refaat, A., Rehm, J., Reitsma, M., Remuzzi, G., Resnikofff, S., Ribeiro, A., Ricci, S., Blancas, M., Roberts, B., Roca, A., Rojas-Rueda, D., Ronfani, L., Roshandel, G., Rothenbacher, D., Roy, A., Roy, N., Ruhago, G., Sagar, R., Saha, S., Sahathevan, R., Saleh, M., Sanabria, J., Sanchez-Nino, M., Sanchez-Riera, L., Santos, I., Sarmiento-Suarez, R., Sartorius, B., Satpathy, M., Savic, M., Sawhney, M., Schaub, M., Schmidt, M., Schneider, I., Schottker, B., Schutte, A., Schwebel, D., Seedat, S., Sepanlou, S., Servan-Mori, E., Shackelford, K., Shaddick, G., Shaheen, A., Shahraz, S., Shaikh, M., Shakh-Nazarova, M., Sharma, R., She, J., Sheikhbahaei, S., Shen, J., Shen, Z., Shepard, D., Sheth, K., Shetty, B., Shi, P., Shibuya, K., Shin, M., Shiri, R., Shiue, I., Shrime, M., Sigfusdottir, I., Silberberg, D., Silva, D., Silveira, D., Silverberg, J., Simard, E., Singh, A., Singh, G., Singh, J., Singh, O., Singh, P., Singh, V., Soneji, S., Soreide, K., Soriano, J., Sposato, L., Sreeramareddy, C., Stathopoulou, V., Stein, D., Stein, M., Stranges, S., Stroumpoulis, K., Sunguya, B., Sur, P., Swaminathan, S., Sykes, B., Szoeke, C., Tabares-Seisdedos, R., Tabb, K., Takahashi, K., Takala, J., Talongwa, R., Tandon, N., Tavakkoli, M., Taye, B., Taylor, H., Ao, B., Tedla, B., Tefera, W., Ten Have, M., Terkawi, A., Tesfay, F., Tessema, G., Thomson, A., Thorne-Lyman, A., Thrift, A., Thurston, G., Tillmann, T., Tirschwell, D., Tonelli, M., Topor-Madry, R., Topouzis, F., Nx, J., Traebert, J., Tran, B., Truelsen, T., Trujillo, U., Tura, A., Tuzcu, E., Uchendu, U., Ukwaja, K., Undurraga, E., Uthman, O., Van Dingenen, R., Van Donkelaar, A., Vasankari, T., Vasconcelos, A., Venketasubramanian, N., Vidavalur, R., Vijayakumar, L., Villalpando, S., Violante, F., Vlassov, V., Wagner, J., Wagner, G., Wallin, M., Wang, L., Watkins, D., Weichenthal, S., Weiderpass, E., Weintraub, R., Werdecker, A., Westerman, R., White, R., Wijeratne, T., Wilkinson, J., Williams, H., Wiysonge, C., Woldeyohannes, S., Wolfe, C., Won, S., Wong, J., Woolf, A., Xavier, D., Xiao, Q., Xu, G., Yakob, B., Yalew, A., Yan, L., Yano, Y., Yaseri, M., Ye, P., Yebyo, H., Yip, P., Yirsaw, B., Yonemoto, N., Yonga, G., Younis, M., Yu, S., Zaidi, Z., Zaki, M., Zannad, F., Zavala, D., Zeeb, H., Zeleke, B., Zhang, H., Zodpey, S., Zonies, D., Zuhlke, L., Vos, T., Lopez, A., and Murray, C.

Published
2016

9. Increased 30-day and 1-year mortality rates and lower coronary revascularisation rates following acute myocardial infarction in patients with autoimmune rheumatic disease

Author

Van Doornum, S, Bohensky, M, Tacey, MA, Brand, CA, Sundararajan, V, Wicks, IP, Van Doornum, S, Bohensky, M, Tacey, MA, Brand, CA, Sundararajan, V, and Wicks, IP

Abstract

INTRODUCTION: It is now well-recognised that patients with autoimmune rheumatic disease (AIRD) have a predisposition to cardiovascular disease that results in increased morbidity and mortality. Following myocardial infarction (MI), patients with rheumatoid arthritis have been shown to have an increased case fatality rate; however, this has not been demonstrated in other forms of AIRD. The aim of this study was to compare case fatality rates following a first MI in patients with AIRD versus the general population. The secondary aim was to compare revascularisation treatment following MI in patients with AIRD versus the general population. METHODS: A retrospective cohort study using two population-based linked databases was undertaken. Cases of first MI from July 2001 to June 2007 were identified based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification, codes. Thirty-day and one-year mortality rates were calculated (all-cause and cardiovascular causes of death). Logistic regression models were fitted to calculate the odds of mortality by AIRD status with adjustment for relevant characteristics. RESULTS: There were 79,390 individuals with a first MI, of whom 1,409 (1.8%) had AIRD. After adjusting for relevant covariates, the odds ratio (OR) for 30-day cardiovascular mortality in patients with AIRD was 1.44 (95% confidence interval (CI): 1.25 to 1.66), and the OR for 12-month cardiovascular mortality was 1.71 (95% CI: 1.51 to 1.94). The 90-day adjusted odds of percutaneous transluminal coronary angioplasty and coronary artery bypass graft were significantly lower in the AIRD group compared with controls (OR: 0.81, 95% CI: 0.70 to 0.94, and OR: 0.52, 95% CI: 0.39 to 0.69, respectively). CONCLUSIONS: We identified a higher risk-adjusted mortality rate for the majority of patients with AIRD at 30 days and 12 months after first MI. We also identified lower post-MI revascularisation rates in the AIRD g

Published
2015

10. The extra resource burden of in-hospital falls: A cost of falls study

Author

Morello, R., Barker, A., Watts, J., Haines, T., Zavarsek, S., Hill, Keith, Brand, C., Sherrington, C., Wolfe, R., Bohensky, M., Stoelwinder, J., Morello, R., Barker, A., Watts, J., Haines, T., Zavarsek, S., Hill, Keith, Brand, C., Sherrington, C., Wolfe, R., Bohensky, M., and Stoelwinder, J.

Abstract

Objective: To quantify the additional hospital length of stay (LOS) and costs associated with in-hospital falls and fall injuries in acute hospitals in Australia. Design, setting and participants: A multisite prospective cohort study conducted during 2011–2013 in the control wards of a falls prevention trial (6-PACK). The trial included all admissions to 12 acute medical and surgical wards of six Australian hospitals. In-hospital falls data were collected from medical record reviews, daily verbal reports by ward nurse unit managers, and hospital incident reporting and administrative databases. Clinical costing data were linked for three of the six participating hospitals to calculate patient-level costs. Outcome measures: Hospital LOS and costs associated with in-hospital falls and fall injuries for each patient admission. Results: We found that 966 of a total of 27 026 hospital admissions (3.6%) involved at least one fall, and 313 (1.2%) at least one fall injury, a total of 1330 falls and 418 fall injuries. After adjustment for age, sex, cognitive impairment, admission type, comorbidity and clustering by hospital, patients who had an in-hospital fall had a mean increase in LOS of 8 days (95% CI, 5.8–10.4; P < 0.001) compared with non-fallers, and incurred mean additional hospital costs of $6669 (95% CI, $3888–$9450; P < 0.001). Patients with a fall-related injury had a mean increase in LOS of 4 days (95% CI, 1.8–6.6; P = 0.001) compared with those who fell without injury, and there was also a tendency to additional hospital costs (mean, $4727; 95% CI, −$568 to $10 022; P = 0.080). Conclusion: Patients who experience an in-hospital fall have significantly longer hospital stays and higher costs. Programs need to target the prevention of all falls, not just the reduction of fall-related injuries.

Published
2015

13. In-hospital falls and fall-related injuries: A protocol for a cost of fall study.

Author

Sherrington C., Stoelwinder J., Brand C., Wolfe R., Bohensky M., Morello R.T., Barker A.L., Haines T., Zavarsek S., Watts J.J., Hill K., Sherrington C., Stoelwinder J., Brand C., Wolfe R., Bohensky M., Morello R.T., Barker A.L., Haines T., Zavarsek S., Watts J.J., and Hill K.

Abstract

Background In-hospital falls are common and pose significant economic burden on the healthcare system. To date, few studies have quantified the additional cost of hospitalisation associated with an in-hospital fall or fall-related injury. The aim of this study is to determine the additional length of stay and hospitalisation costs associated with in-hospital falls and fall-related injuries, from the acute hospital perspective. Methods and design A multisite prospective study will be conducted as part of a larger falls-prevention clinical trial-the 6-PACK project. This study will involve 12 acute medical and surgical wards from six hospitals across Australia. Patient and admission characteristics, outcome and hospitalisation cost data will be prospectively collected on approximately 15 000 patients during the 15-month study period. A review of all in-hospital fall events will be conducted using a multimodal method (medical record review and daily verbal report from the nurse unit manager, triangulated with falls recorded in the hospital incident reporting and administrative database), to ensure complete case ascertainment. Hospital clinical costing data will be used to calculate patient-level hospitalisation costs incurred by a patient during their inpatient stay. Additional hospital and hospital resource utilisation costs attributable to in-hospital falls and fall-related injuries will be calculated using linear regression modelling, adjusting for a priori-defined potential confounding factors. Discussion This protocol provides the detailed statement of the planned analysis. The results from this study will be used to support healthcare planning, policy making and allocation of funding relating to falls prevention within acute hospitals.

Published
2014

14. Lifetime Risk of Total Hip Replacement Surgery and Temporal Trends in Utilization: A Population-Based Analysis

Author

Bohensky, M, Ackerman, I, de Steiger, R, Gorelik, A, Brand, C, Bohensky, M, Ackerman, I, de Steiger, R, Gorelik, A, and Brand, C

Abstract

OBJECTIVE: To investigate lifetime risk of total hip replacement (THR) surgery in the state of Victoria, Australia and to describe temporal trends in THR incidence. METHODS: We analyzed a retrospective population-based longitudinal cohort of patients who received a primary THR in Victoria from 1998-2009. The factors potentially contributing to changes in lifetime risk were also examined, including temporal changes in THR incidence according to health care setting (public versus private), socioeconomic status, and geographic location (regional versus metropolitan). RESULTS: We identified 45,775 patients receiving THR over the time period. For a woman age 20-29 years, the mortality-adjusted lifetime risk rose significantly over time, from 8.49% (95% confidence interval [95% CI] 8.23-8.69%) in 1999-2000 to 10.30% (95% CI 10.07-10.49%) in 2007-2008. For a man age 20-29 years, the mortality-adjusted lifetime risk also increased significantly, from 9.29% (95% CI 8.97-9.58%) in 1999-2000 to 10.27% (95% CI 9.95-10.48%) in 2004-2005, but in contrast to the pattern observed for women, it decreased slightly in 2007-2008 (9.90% [95% CI 9.60-10.16%]). We also identified an increasing number of THRs in private hospitals, in people in middle and low socioeconomic groups, and in rural areas. CONCLUSION: The lifetime risk of THR for women was similar to men, despite a higher burden of hip osteoarthritis, and this warrants further investigation. However, increases in the number of THR procedures performed for patients in regional areas and in lower socioeconomic groups suggest some reductions over time in known disparities.

Published
2014

15. Statin initiation and treatment non-adherence following a first acute myocardial infarction in patients with inflammatory rheumatic disease versus the general population

Author

Bohensky, M, Tacey, M, Brand, C, Sundararajan, V, Wicks, I, Van Doornum, S, Bohensky, M, Tacey, M, Brand, C, Sundararajan, V, Wicks, I, and Van Doornum, S

Abstract

INTRODUCTION: To compare statin initiation and treatment non-adherence following a first acute myocardial infarction (MI) in patients with inflammatory rheumatic disease (IRD) and the general population. METHODS: We conducted a retrospective cohort study using a population-based linked database. Cases of first MI from July 2001 to June 2009 were identified based on International Classification of Diseases (ICD-10-AM) codes. Statin initiation and adherence was identified based on pharmaceutical claims records. Logistic regression was used to assess the odds of statin initiation by IRD status. Non-adherence was assessed as the time to first treatment gap using a Cox proportional hazards model. RESULTS: There were 18,518 individuals with an index MI over the time period surviving longer than 30 days, of whom 415 (2.2%) were IRD patients. The adjusted odds of receiving a statin by IRD status was significantly lower (OR =0.69, 95% CI: 0.55 to 0.86) compared to the general population. No association between IRD status and statin non-adherence was identified (hazard ratio (HR) =1.12, 95% CI: 0.82 to 1.52). CONCLUSIONS: Statin initiation was significantly lower for people with IRD conditions compared to the general population. Once initiated on statins, the proportion of IRD patients who adhered to treatment was similar to the general population. Given the burden of cardiovascular disease and excess mortality in IRD patients, encouraging the use of evidence-based therapies is critical for ensuring the best outcomes in this high risk group.

Published
2014

16. Clinical data linkages in spinal cord injuries (SCI) in Australia: What are the concerns?

Author

Moon, J, Galea, MP, Bohensky, M, Moon, J, Galea, MP, and Bohensky, M

Abstract

Clinical data linkage amongst patients with Spinal Cord Injury (SCI) is a challenge, as the Australian Health System is fragmented and there is lack of coordination between multiple data custodians at the state and federal levels, private and public hospitals, and acute and allied health sectors. This is particularly problematic in chronic conditions such as SCI, where multiple data custodians collect data on patients over long periods of time. The author presents findings based on interviews with a range of data custodians for SCI categorized as clinical, statutory, and financial data custodians. It is found that data are kept in different silos, which are not coordinated, hence duplication exists and patient information that exists on many different databases is inconsistently updated. This chapter describes the importance of Clinical Data Linkage for healthcare in predicting disease trajectories for SCI and discusses how administrative and clinical data are collected and stored and some of the challenges in linking these datasets.

Published
2014

17. Trends in sickness certification of injured workers by general practitioners in Victoria, Australia

Author

Ruseckaite, R., Collie, A., Bohensky, M., Brijnath, Bianca, Kosny, A., Mazza, D., Ruseckaite, R., Collie, A., Bohensky, M., Brijnath, Bianca, Kosny, A., and Mazza, D.

Abstract

Background: General practitioners (GPs) play a critical role in facilitating injured workers return to work via their ability to certify capacity to return to employment. However, little is known about the sickness certification patterns of GPs in the context of workers' compensation claims. Aim: To determine if GPs' sickness certification behaviour has changed between 2003 and 2010 in Victoria, Australia. Method: Retrospective population-based cohort study of all injured workers with an accepted compensation claim. Sickness certification rates per 1,000 working population per annum were calculated. General regression models adjusted for workers' age and annual claim number were fitted to summarize changes in count and duration (expressed as incidence rate ratios or IRRs) of unfit for work (UFW) versus alternate duties (ALT) certificates within six categories of work-related injury and disease. Results: 92,134 UFW and 28,293 ALT certificates were identified. A significant decrease in the unadjusted annual certification rates per 1,000 working population was observed. However, after adjusting for the annual number of claims and age, the IRRs of certificates increased over time. The rate of injuries and IRRs of certificates varied across affliction categories, IRRs being higher in mental health conditions in women than in men (IRR: 0.40, 95 % CI 0.38-0.41 vs. IRR: 0.17, 95 % CI 0.16-0.18). The duration of certificates remained stable, with the ALT being longer than UFW certificates in all claimants. Conclusion: Our findings indicate that GPs in Victoria issue an increasing number of UFW sickness certificates each year. Further research is required to investigate the reasons for such practises.

Published
2014

18. Predictors of health care use among patients with or at high risk of atherothrombotic disease: Two-year follow-up data

Author

Ademi, Z., Liew, D., Gorelik, A., Bohensky, M., Zomer, E., Hollingsworth, B., Steg, G., Bhatt, D., Reid, Christopher, Ademi, Z., Liew, D., Gorelik, A., Bohensky, M., Zomer, E., Hollingsworth, B., Steg, G., Bhatt, D., and Reid, Christopher

Abstract

Background Atherothrombotic diseases are the leading health problems in the world, both in terms of morbidity and mortality. This study aimed to identify and quantify the predictors of medication, hospital and outpatient service use among patients with or at high risk of atherothrombotic disease. Methods Two-year follow-up data were analyzed for 2873 Australian participants of the Reduction of Atherothrombosis for Continued Health (REACH) registry. The analysis was performed using generalized linear models with Poisson and Gamma distributions and log link function. Results Participants with hypercholesterolemia, diabetes, hypertension, atrial fibrillation (AF), and history of coronary artery disease (CAD) used more medications (p < 0.0001). The presence of diabetes predicted higher number of outpatient visits (RR = 1.09, 95% CI: 1.07-1.11), as did AF (RR = 1.10, 95% CI: 1.08-1.12). The presence of peripheral artery disease (PAD) regardless of ankle brachial index (ABI) status (abnormal or normal) increased the use of outpatient visits (RR = 1.24, 95% CI: 1.20-1.29 and RR = 1.12, 95% CI: 1.08-1.15), compared to those without PAD. Similarly, the presence of PAD regardless of ABI status increased the risk of vascular interventions, including coronary angioplasty, carotid surgery, amputation affecting lower-limb and peripheral bypass graft (RR = 3.64, 95% CI: 2.01-6.60) (RR = 2.8, 95% CI: 1.6-4.92) compared to patients without PAD. Conclusions The presence of PAD regardless of ABI status predicts a higher number of outpatient visits, non-fatal cardiovascular endpoints and vascular-interventions, while diabetes predicts higher pharmaceutical use and outpatient visits. AF predicts the higher number of outpatient visits and non-fatal cardiovascular events. © 2014 Elsevier Ireland Ltd.

Published
2014

19. Is a biomarker-based diagnostic strategy for invasive aspergillosis cost effective in high-risk haematology patients?

Author

Macesic, N., Morrissey, C. O., Liew, D., Bohensky, M. A., Chen, S. C.-A., Gilroy, N. M., Milliken, S. T., Szer, J., and Slavin, M. A.

Abstract

Empirical antifungal therapy is frequently used in hematology patients at high risk of invasive aspergillosis (IA), with substantial cost and toxicity. Biomarkers for IA aim for earlier and more accurate diagnosis and targeted treatment. However, data on the costeffectiveness of a biomarker-based diagnostic strategy (BDS) are limited. We evaluated the cost effectiveness of BDS using results from a randomized controlled trial (RCT) and individual patient costing data. Data inputs derived from a published RCT were used to construct a decision-analytic model to compare BDS (Aspergillus galactomannan and PCR on blood) with standard diagnostic strategy (SDS) of culture and histology in terms of total costs, length of stay, IA incidence, mortality, and years of life saved. Costs were estimated for each patient using hospital costing data to day 180 and follow-up for survival was modeled to five years using a Gompertz survival model. Treatment costs were determined for 137 adults undergoing allogeneic hematopoietic stem cell transplant or receiving chemotherapy for acute leukemia in four Australian centers (2005-2009). Median total costs at 180 days were similar between groups (US$78,774 for SDS [IQR US$50,808-123,476] and US$81,279 for BDS [IQR US$59,221-123,242], P = .49). All-cause mortality was 14.7% (10/68) for SDS and 10.1% (7/69) for BDS, (P = .573). The costs per life-year saved were US$325,448, US$81,966, and US$3,670 at 180 days, one year and five years, respectively. BDS is not cost-sparing but is cost-effective if a survival benefit is maintained over several years. An individualized institutional approach to diagnostic strategies may maximize utility and cost-effectiveness. [ABSTRACT FROM AUTHOR]

Published
2017
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22. In-hospital falls and fall-related injuries: a protocol for a cost of fall study.

Author

Morello, R., Barker, A., Haines, T., Zavarsek, S., Hill, Keith, Brand, C., Sherrington, C., Wolfe, R., Bohensky, M., Stoelwinder, J., Morello, R., Barker, A., Haines, T., Zavarsek, S., Hill, Keith, Brand, C., Sherrington, C., Wolfe, R., Bohensky, M., and Stoelwinder, J.

Abstract

BACKGROUND: In-hospital falls are common and pose significant economic burden on the healthcare system. To date, few studies have quantified the additional cost of hospitalisation associated with an in-hospital fall or fall-related injury. The aim of this study is to determine the additional length of stay and hospitalisation costs associated with in-hospital falls and fall-related injuries, from the acute hospital perspective.METHODS AND DESIGN: A multisite prospective study will be conducted as part of a larger falls-prevention clinical trial—the 6-PACK project. This study will involve 12 acute medical and surgical wards from six hospitals across Australia. Patient and admission characteristics, outcome and hospitalisation cost data will be prospectively collected on approximately 15 000 patients during the 15-month study period. A review of all in-hospital fall events will be conducted using a multimodal method (medical record review and daily verbal report from the nurse unit manager, triangulated with falls recorded in the hospital incident reporting and administrative database), to ensure complete case ascertainment. Hospital clinical costing data will be used to calculate patient-level hospitalisation costs incurred by a patient during their inpatient stay. Additional hospital and hospital resource utilisation costs attributable to in-hospital falls and fall-related injuries will be calculated using linear regression modelling, adjusting for a priori-defined potential confounding factors.DISCUSSION: This protocol provides the detailed statement of the planned analysis. The results from this study will be used to support healthcare planning, policy making and allocation of funding relating to falls prevention within acute hospitals.

Published
2013

23. Experience with practice guidelines for medico-legal death investigations: the case of falls-related deaths in hospital.

Author

Bohensky M, Emmett SL, Ibrahim JE, Ranson DL, Bohensky, M, Emmett, S L, Ibrahim, J E, and Ranson, D L

Abstract

Western philosophical and political thought has focussed on the significance of individual relativism. The legal system's approach to the investigation and regulation of medical practice is generally ad hoc and based on case law. In contrast, medical knowledge and understanding is progressively shifting towards a system of taxonomies and norms. Clinical guidelines and evidence-based medical practice are now commonplace in clinical practice. Due to the polarity of professional frameworks underpinning medicine and law, there has been an on-going struggle for the successful use of medical law that benefits both the quality of medical practice as well as its practitioners. This paper discusses the principles in developing and implementing a standard investigation tool for the coronial sector using the Falls Investigation Standard as an example, which has been in use for 12 months in the state of Victoria, Australia. It is hoped that using a standardised tool can balance the often conflicting tensions between medical and legal sectors by enabling an in-depth review of each issue while also strengthening the health system's capacity for self-regulation. [ABSTRACT FROM AUTHOR]

Published
2005

27. WORLD WITHOUT BORDERS: INTEGRATING CLINICAL PERSPECTIVES INTO THE CORONIAL JURISDICTION IN VICTORIA, AUSTRALIA.

Author

Bohensky, M., Ibrahim, J. E., O'Brien, A. J., Emmett, S. L., Newman, E., Charles, A., Young, C., and Ranson, D. L.

Abstract

A professional world without borders would allow for more appropriate collaboration between the Coroner's office and the healthcare sector in their endeavours to improve patient safety. In Victoria (Australia), the Clinical Liaison Service draws on the distinct experiences and expertise of medical, nursing and research personnel to evaluate clinical evidence for the investigation of healthcare deaths reported to the State Coroner's Office. This approach allows for greater intersectoral collaboration between the Coroner's office and healthcare sector than a traditional English-style coronial system that relies on the expertise of coroners, forensic pathologists and police officers to investigate unexpected deaths. Encouraging collaboration between these two sectors may have averted or at least mitigated the atrocities caused by Harold Shipman or the events at Bristol's Royal Infirmary. This paper describes the work processes employed by the Clinical Liaison Service (CLS) to investigate healthcare deaths in a coronial setting. To describe how this work has fostered the advancement of patient care. [ABSTRACT FROM AUTHOR]

Published
2006

33. Substantial rise in the lifetime risk of primary total knee replacement surgery for osteoarthritis from 2003 to 2013: an international, population-level analysis.

Author

Ackerman IN, Bohensky MA, de Steiger R, Brand CA, Eskelinen A, Fenstad AM, Furnes O, Garellick G, Graves SE, Haapakoski J, Havelin LI, Mäkelä K, Mehnert F, Pedersen AB, and Robertsson O

Subjects
Adult, Aged, Australia, Denmark, Female, Finland, Humans, Male, Middle Aged, Norway, Retrospective Studies, Risk, Sex Factors, Sweden, Arthroplasty, Replacement, Knee trends, Osteoarthritis, Knee surgery
Abstract

Objective: To estimate and compare the lifetime risk of total knee replacement surgery (TKR) for osteoarthritis (OA) between countries, and over time., Method: Data on primary TKR procedures performed for OA in 2003 and 2013 were extracted from national arthroplasty registries in Australia, Denmark, Finland, Norway and Sweden. Life tables and population data were also obtained for each country. Lifetime risk of TKR was calculated for 2003 and 2013 using registry, life table and population data., Results: Marked international variation in lifetime risk of TKR was evident, with females consistently demonstrating the greatest risk. In 2013, Finland had the highest lifetime risk for females (22.8%, 95%CI 22.5-23.1%) and Australia had the highest risk for males (15.4%, 95%CI 15.1-15.6%). Norway had the lowest lifetime risk for females (9.7%, 95%CI 9.5-9.9%) and males (5.8%, 95%CI 5.6-5.9%) in 2013. All countries showed a significant rise in lifetime risk of TKR for both sexes over the 10-year study period, with the largest increases observed in Australia (females: from 13.6% to 21.1%; males: from 9.8% to 15.4%)., Conclusions: Using population-based data, this study identified significant increases in the lifetime risk of TKR in all five countries from 2003 to 2013. Lifetime risk of TKR was as high as 1 in 5 women in Finland, and 1 in 7 males in Australia. These risk estimates quantify the healthcare resource burden of knee OA at the population level, providing an important resource for public health policy development and healthcare planning., (Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.)

Published
2017
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