Care of the critically ill woman in childbirth

Care of the critically ill woman in childbirth; enhanced maternal care
Faculty of Intensive Care Medicine, 15 August 2018

• Recommendations relevant to the care of pregnant or recently pregnant, acutely or chronically unwell women, who require acute hospital maternity and critical care specialist services. 

National Genomic Test Directories

National Genomic Test Directories
NHS England 3 August 2018

• From October 2018 the National Genomic Test Directory will specify which genomic tests are commissioned by the NHS in England, the technology by which they are available, and the patients who will be eligible to access to a test. 
• Two directories are available - Rare and Inherited Disorders and Cancer.

Frailty indexes in perioperative and critical care: A systematic review.

Frailty indexes in perioperative and critical care: A systematic review.
Arch Gerontol Geriatr. 2018 Aug 19;79:88-96.

• Analysis of nine prospective and four retrospective cohort studies (enrolling 2539 patients) which utilised a frailty index consisting of ≥30 health deficits concludes that frail patients are at significantly increased risk in critical illness and the perioperative period.

Abstract

The impact of establishing a medical high dependency unit on intensive care unit workload, case mix, and mortality

Evaluating service development in critical care: The impact of establishing a medical high dependency unit on intensive care unit workload, case mix, and mortality
Journal of the Intensive Care Society v19(3) 1 August 2018

Conclusion: The opening of a medical high dependency unit had a minimal impact on the intensive care unit.There was, in all likelihood, an unmet need—of less seriously ill patients, who were previously looked after on a normal ward, but did not require intensive care unit admission—who are now cared for in the new medical high dependency unit.

Study: Location: Aberdeen, Single-center, 11-year retrospective study of patients admitted to the general intensive care unit, before and after the opening of the medical high dependency unit, n=3209 

Abstract

Risk scores to guide referral decisions for people with suspected ovarian cancer

Risk scores to guide referral decisions for people with suspected ovarian cancer in secondary care: a systematic review and cost-effectiveness analysis.
Health Technol Assess 2018;22(44)

• This assessment considered how best to combine information from blood tests, ultrasound and clinical examinations (signs and symptoms reported by the patient and menopausal status), in order to decide when a woman is more likely to have ovarian cancer and should therefore be referred to a specialist centre for further investigations (including biopsy or surgery) and treatment.

Frailty and Clinical Outcomes in Heart Failure: A Systematic Review and Meta-analysis.

Frailty and Clinical Outcomes in Heart Failure: A Systematic Review and Meta-analysis.

J Am Med Dir Assoc. 2018 Jul 31. pii: S1525-8610(18)30329-3.

• Frailty is a significant predictor of all-cause mortality and hospital readmissions in HF. Assessment and close monitoring of frailty status of heart failure patients can potentially better guide clinical management of this population.

Abstract

The PROMIS study

Multiparametric MRI to improve detection of prostate cancer compared with transrectal ultrasound-guided prostate biopsy alone: the PROMIS study
Health Technol Assess 2018;22(39)

• Adding multiparametric MRI as an initial test prior to prostate biopsy can reduce the proportion of men having unnecessary biopsies and improve the detection of clinically significant prostate cancer.