| Carmel Montgomery, Colleen M. Norris, Darryl B. Rolfson, Henry Stelfox, Mohamad A. Zibdawi, Sean Bagshaw, Thanh Nguyen, Steven R. Meyer
There is limited information about the impact of frailty on public payer costs in cardiac surgery. This study aimed to determine quality-adjusted life-years (QALYs) and costs associated with pre-operative frailty in patients referred for cardiac surgery.
Highlights•One third of ICU deaths occur within 24 hours of admission.•Patients who die early are older, more likely frail and receive more advanced life support.•Correlates of early death include age, acuity and Emergency Department admission.•Future work should explore the role of clinician and family decision-making in this group. AbstractPurposeTo describe…
A substantial proportion of patients admitted to intensive care units (ICUs) are frail; however, the epidemiology of frailty has not been explored at a population-level. Following implementation of a validated frailty measure into a provincial ICU clinical information system, we describe the population-based prevalence and outcomes of frailty in patients admitted to ICUs.
Background: Antiviral treatment for chronic hepatitis B is costly, which presents challenges for universal drug coverage for the estimated 480 000 people with the disease in Canada. We appraised criteria for reimbursement of chronic hepatitis B antivirals by public drug plans in Canada.
Fetal Alcohol Spectrum Disorder (FASD) is a preventable disorder caused by maternal alcohol consumption and marked by a range of physical and mental disabilities. Although recognized by the scientific and medical community as a clinical disorder, no internationally standardized diagnostic tool yet exists for FASD.
Using sources ranging from the biblical Book of Judges (pre-1700) up until the first public health bulletin (1977), we seek to provide an overview of the academic debate around early historical accounts ostensibly attributed to the awareness of alcohol as a prenatal teratogen as well as to describe the social and political influences that sculpted developments leading to the public…
| Arun Jesudian, Brett E Fortune, Nicole T Shen, Robert S Brown Jr, Russell Rosenblatt, Stephen Congly, Yecheskel Schneider, Yunseok Namn
Treatment options for recurrent ascites resulting from decompensated cirrhosis include serial large-volume paracentesis and albumin infusion (LVP+A) or insertion of a transjugular intrahepatic portosystemic shunt (TIPS). Insertion of TIPSs with covered stents during early stages of ascites (early TIPS, defined as 2 LVPs within the past 3 weeks and <6 LVPs in the prior 3 months)…
Vertical transmission of hepatitis B virus (HBV) can occur despite immunoprophylaxis in mothers with high HBV DNA levels (>5-7 log10 IU/ml). Quantitative hepatitis B surface antigen (qHBsAg) testing could be used as a surrogate marker to identify high viral load carriers, but there is limited data in pregnancy. We conducted a prospective observational study to determine…
Cost is a critical element in almost all public or private decisions regarding health care and human services. While cost as “opportunity cost” is straightforward on a conceptual level, making the concept operational, quantifying costs and integrating such information into decision analysis is a continuing challenge. An IHE conference, “On the State of the Art…