Impact of frailty on in-hospital outcomes in nonagenarian ICU patients: a binational multicenter analysis of 8,220 cases.

Background: As global populations age, the number of nonagenarians admitted to intensive care units (ICUs) is rising. Frailty, a multidimensional syndrome marked by diminished physiological reserves, has been associated with adverse outcomes in older ICU patients. However, evidence remains limited regarding its prognostic significance in nonagenarians, who represent a unique and rapidly growing subset of critically ill patients.

Obesity and nutrition risk in patients admitted to intensive care after cardiac arrest: A multicentre cohort study.

Background: The double burden of malnutrition, defined as the co-existence of overnutrition with undernutrition, is increasing in prevalence globally. Yet, little is known about its impact on patients with cardiac arrest. We examined the association between malnutrition and outcomes in patients admitted to intensive care units (ICU) after cardiac arrest.

Mortality Trends Across Key Diagnostic Groups in Australian and New Zealand ICUs Over the Past 30 Years.

Objectives: The Australia and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD) has been operational for 3 decades. It is important to understand how mortality outcomes have changed across diagnostic groups over time to facilitate the planning of future healthcare resources. We evaluated the trends in risk-adjusted mortality for ICU patients over the last 30 years.

A prediction model for 'ICU mortality or prolonged ICU stay' in critically unwell patients with acute pancreatitis: insights from a 2003-2020 cohort analysis using the ANZICS-CORE database.

Objective: Critically unwell patients with acute pancreatitis (AP) are at increased risk of mortality and prolonged ICU length of stay (LOS). We quantified the frequency, risk factors and complications of prolonged ICU LOS in a large cohort of critically unwell adult patients with AP and developed a model to predict a low-risk trajectory 'survived ICU with ICU LOS ≤7 days' versus a high-risk trajectory 'ICU mortality or ICU LOS > 7 days'.

Methods: A retrospective cohort analysis of adult patients admitted to Australian and New Zealand ICUs with AP between 2003 and 2020 was conducted using the Australian and New Zealand Intensive Care Society Centre for Outcome Reporting and Evaluation database.

Long-term outcomes after ICU admission in critically ill patients with liver cirrhosis: An Australian state-wide cohort study.

Background: Patients with liver cirrhosis requiring intensive care unit (ICU) admission have a high in-hospital mortality, yet long-term mortality and predictors of mortality in survivors remain unknown.

Methods: All patients with liver cirrhosis admitted to 27 ICUs in Victoria, Australia, between 2007 and 2018 reported to the Australian and New Zealand Intensive Care Society Adult Patient Database were included. Poisson regression and Cox regression were used to explore factors associated with in-hospital mortality and all-cause 12-month mortality.

Association between Full Moon Day overdose-related intensive care unit admissions and hospital mortality: a medical enigma or mere myth?

Background: There is limited evidence on whether Full Moon Day is linked to drug overdoses severe enough to need intensive care unit (ICU) admissions.

Aims: To investigate the association between Full Moon Day overdose-related ICU admissions and hospital mortality.

Methods: This retrospective multicentre observational study that included data from 172 ICUs across Australia and New Zealand reported to the Australia New Zealand Intensive Care Society Adult Patient Database.

Patient and Family Engagement in Australian and New Zealand Adult Critical Care Trials.

Background: Engaging patients and families in critical care research is recognised as best practice. The extent of engagement in critical care trials in Australia and New Zealand is unknown, following introduction of national guidelines in 2016.

Objective: To assess the extent of patient and family engagement in adult critical care research studies endorsed by the Australia and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG).

Admission to specialised neurocritical units and association with clinical outcomes.

Background: Globally, managing critically ill adults with acute brain injuries (ABIs) in specialised neurocritical units (NCCUs) is associated with improved survival, but this has not been assessed in Australia. This study aims to determine in adults with an ABI if admission to a general intensive care unit (ICU) or a NCCU was associated with a difference in outcomes.

Methods: Australian ICUs were surveyed regarding NCCU capabilities via the Australian and New Zealand Intensive Care Society (ANZICS).

Persistent critical illness and long-term survival in cardiac surgery: A multicentre cohort study.

Background: Persistent critical illness (PerCI) is associated with poorer in-hospital outcomes in patients admitted to an intensive care unit (ICU), and in patients receiving cardiac surgery, yet its association with longer-term survival remains unclear.

Objective: We investigated the association between PerCI and long-term survival in patients receiving cardiac surgery.

Methods: In this retrospective, multicentre observational cohort study using the Australia and New Zealand Intensive Care Society Adult Patient Database, we included all adults (≥16 years) admitted to 83 ICUs across Australia and New Zealand after cardiac surgery (coronary artery bypass graft, valvular replacement, or both) from January 1 2018 to December 31 2022 for Australia and 31 December 2020 for New Zealand.

The Varying Impact of Frailty With Increasing Body Mass Index on Survival Up To 3 Years After ICU Admission: A Retrospective Registry-Based Study.

Objectives: Frailty is associated with poorer outcomes in critical illness, but it is unclear if this relationship is consistent across different body mass index (BMI) levels.

Design: A retrospective multicentric registry-based observational study using the Australia New Zealand Intensive Care Society Adult Patient Database.

Setting: Criticallly ill patients admitted to 1170 ICUs between January 1, 2018, and March 31, 2022.

Discharge to Nonhome Locations and Association With Long-term Survival After Cardiac Surgery in Australia and New Zealand Intensive Care Units: A Retrospective Multicenter Cohort Study.

Objectives: Nonhome discharge (NHD) after cardiac surgery has increased in Australia and New Zealand, but its effect on long-term survival is unclear. This study aimed to assess whether NHD, compared with home discharge (HD), was associated with decreased survival up to 4 years after surgery. Additional objectives included evaluating the effects of discharge location, age, surgery types, and emergency status on long-term survival.

Outcomes of critical illness in peoples with Advanced HIV Disease: 30 years of binational data.

Background: Prior to the advent of effective Anti-Retroviral Therapy (ART), ICU admission rates for people with Advanced HIV Disease (AHD) were low, reflecting high mortality and limited treatment options. Despite improvements in ICU and HIV care, longitudinal outcome data in critically ill people with AHD are limited.

Methods: We performed a retrospective cohort study of ICU admissions in Australia and New Zealand between January 1993 and December 2022, in patients with a comorbid diagnosis of AHD.

The Novel Use of Daratumumab in the Treatment of Refractory Autoimmune Pulmonary Alveolar Proteinosis.

Autoimmune pulmonary alveolar proteinosis (aPAP) is caused by circulating anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) auto-antibodies that impair alveolar macrophage and neutrophil function. Macrophage dysfunction leads to accumulation of protein- and lipid-rich surfactant within alveoli, impairing gas exchange and leading to respiratory failure. Standard treatments include whole lung lavage (WLL) as first-line therapy, nebulised replacement of GM-CSF, and in refractory cases, lymphocyte depletion, immunosuppression, or lung transplantation.

The Impact of the COVID-19 Pandemic on Intensive Care Nurses' Experience in Providing Extracorporeal Membrane Oxygenation Care.

To explore the challenges and describe the impact of the COVID-19 pandemic on intensive care nurses' experience in providing ECMO care in a high-volume Australian ICU ECMO centre that provides Veno-Venous (V-V), Veno-Arterial (V-A), and Extracorporeal Cardiopulmonary Resuscitation (E-CPR) ECMO support. A qualitative descriptive methodology was employed, involving semi-structured individual interviews with 30 specialist ECMO-trained intensive care nurses. An open inductive thematic analysis was conducted, with four main themes identified; (1) demand on ECMO trained critical care nurses (2) nurses' professional commitment, (3) physical and mental impact of isolation, and (4) adaptive training and education.

Long-Term Functional Outcomes in the First 12 Months After VA-ECMO in Adult Patients: A Prospective, Multicenter Study.

Background: Long-term outcomes and quality of life have been identified as core patient-centered outcomes for venoarterial extracorporeal membrane oxygenation (VA-ECMO) research. The aim of this study is to investigate the incidence of death or new disability at 12 months after the initiation of VA-ECMO.

Methods: Prospective, multicenter, registry-embedded cohort study in 26 hospitals in Australia and New Zealand from February 2019 through April 2023.

Frailty and Long-Term Survival in Patients With Critical Illness After Nonhome Discharge: A Retrospective Cohort Study.

Importance: Patients with frailty are more frequently discharged to rehabilitation or residential aged care facility (RACF), defined as nonhome discharge, than those without frailty. An increase in nonhome discharge is considered to be one of the collateral "costs" associated with declining hospital mortality. However, it is unclear whether this association applies to patients with frailty, particularly in the long term.

Frailty and long-term survival of non-cancer patients admitted to intensive care after surgery: a retrospective multicentre cohort study.

Background: As the global population ages and older patients undergo surgery, understanding the association between frailty and postoperative outcomes is crucial to informed decision-making and patient care. There is a lack of research assessing the association between frailty and long-term outcomes in patients admitted to ICUs after surgery.

Methods: We conducted a multicentre retrospective cohort study using Australian and New Zealand Intensive Care Society Adult Patient Database, linked with the Australian National Death Index.

Optimal Hospital Volume to Minimize Postoperative Mortality After Esophagectomy for Cancer in Low Population Density Countries: A Binational Study of Australia and New Zealand.

Background: A relationship between hospital volume and postoperative mortality following esophagectomy for cancer has been reported in Europe and USA, leading to centralization of surgery for esophageal cancer in some countries. It is unclear if this is replicated in countries with low population density such as Australia and New Zealand (ANZ). This study determined the relationship between hospital volume and mortality following esophagectomy in ANZ to define optimal hospital caseload.

A Prospective double-blind, randomised controlled trial comparing angiotensin II to norepinephrine to reduce length of hospital stay in cardiac surgery patients (the PORTHOS study protocol).

Introduction: Cardiac surgery is frequently associated with vasoplegia and vasopressor treatment. Both may be associated with postoperative complications and prolonged length of stay. The most frequently used vasopressor is norepinephrine.

Prevalence, Timing, and Predictors of Patients Who Had New and/or Updated Goals of Care While in the ICU: A Multicenter Retrospective Study.

Objectives: Timely documentation of patient-concordant goals of care (GOC) in the ICU aims to promote patient autonomy and patient-centered care where the harms of interventions outweigh the potential benefits. This study examined the prevalence, timing, and predictors of ICU patients undergoing new and updated GOC documentation events while in the ICU.

Design: Multicenter retrospective study.

Organ donation from extracorporeal membrane oxygenation and ventricular assist devices in Victoria, Australia: Characteristics and trends.

Objective: To describe the characteristics and the trend of organ donation from donors on extracorporeal membrane oxygenation (ECMO) or ventricular assist devices (LVAD).

Design: Retrospective, observational, cohort study from June 2014 to June 2021.

Setting: A multicentre study in Victoria, Australia, using DonateLife Victoria databases.

Intensive care admissions for adults with treated kidney failure in Australia: A national retrospective cohort study.

Objective: Limited data are available on intensive care unit (ICU) admissions for adults receiving kidney replacement therapy (KRT - dialysis or transplantation) in Australia. Our aim is to characterise admissions for patients receiving long-term dialysis and kidney transplant recipients relative to the general intensive care population in Australia.

Design: Retrospective registry-based data linkage cohort study.

Characteristics, outcomes, and complications among nonagenarian and centenarian patients admitted to the intensive care unit: a scoping review.

Introduction: Nonagenarians and centenarians are a growing and vulnerable groups of patients admitted to ICU. There is limited information on their characteristics, outcomes, and complications.

Methods: We performed a scoping review of studies focused on nonagenarians and centenarians admitted to ICU.