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  1. Article ; Online: Patient-Reported Outcome Measures in High-Risk Medical Device Registries: A Scoping Review.

    Merenda, Michelle / Earnest, Arul / Ruseckaite, Rasa / Tse, Wai Chung / Elder, Elisabeth / Hopper, Ingrid / Ahern, Susannah

    Aesthetic surgery journal. Open forum

    2024  Volume 6, Page(s) ojae015

    Language English
    Publishing date 2024-03-16
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2631-4797
    ISSN (online) 2631-4797
    DOI 10.1093/asjof/ojae015
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  2. Article ; Online: Clinical concern and the deteriorating patient: a review of rapid response 2018–20.

    Forcey, Dana S / Dyer, Jessamy C / Hopper, Ingrid K

    Australian health review : a publication of the Australian Hospital Association

    2022  Volume 46, Issue 6, Page(s) 679–685

    Abstract: Objective To investigate demographics, clinical patterns and outcomes of rapid response reviews in hospital, reviewing indications for and outcomes of rapid response reviews initiated for clinical concern and to understand the role of clinical concern in ...

    Abstract Objective To investigate demographics, clinical patterns and outcomes of rapid response reviews in hospital, reviewing indications for and outcomes of rapid response reviews initiated for clinical concern and to understand the role of clinical concern in identifying the deteriorating patient and at-risk patient populations. Method This was a retrospective analysis of General Medical inpatients at Alfred Hospital from 1 January 2018 to 31 July 2020. Data extraction from electronic medical records identified patients who had a rapid response review during admission. Demographic and clinical data, investigations and clinical outcomes from rapid response reviews were investigated. Comparisons were performed using χ 2 or Fisher's exact test where appropriate. Odds ratios and 95% confidence intervals were calculated for factors associated with rapid response reviews for clinical concern and clinical outcomes. Results There were 10 797 admissions of 7409 individual patients. There were 2359 rapid response reviews during the study period, occurring in 13% of admissions. Patients were majority female (50.4%), and the median age was 79 ± 17.6 years. Rapid response reviews were for cardiovascular (46.8%), respiratory (25.3%) and neurological (14.3%) indications. A total of 11% of rapid response reviews (n  = 258) were for clinical concern. Inpatient falls accounted for a significant proportion of rapid response reviews for clinical concern. Reviews were more common in older patients, those admitted after-hours, and patients with disabilities. The latter group weremore likely to have rapid response reviews for clinical concern. Rapid response reviews initiated for clinical concern were more likely than those initiated for standard criteria to change patients' clinical status, particularly the withdrawal of active management. Conclusions Rapid response reviews for clinical concern are important triggers to identify clinical deterioration in vulnerable patients. Reviews were initiated for clinical concern were more likely than those initiated for standard criteria to result in a change in patients' resuscitation status and care trajectory. Clinician concern, even when prompting review for parameters outside of standard clinical review criteria, remains an important factor in recognising the deteriorating patient.
    MeSH term(s) Humans ; Female ; Aged ; Middle Aged ; Aged, 80 and over ; Retrospective Studies ; Social Group
    Language English
    Publishing date 2022-10-02
    Publishing country Australia
    Document type Review ; Journal Article
    ZDB-ID 639155-2
    ISSN 1449-8944 ; 0159-5709 ; 0156-5788
    ISSN (online) 1449-8944
    ISSN 0159-5709 ; 0156-5788
    DOI 10.1071/AH22045
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  3. Article ; Online: Palliative Care Utilisation and Outcomes in Patients Admitted for Heart Failure in a Victorian Healthcare Service.

    Ye, Sylvia / Corbett, Cathy / Dennis, Adelaide S M / Jape, Dylan / Patel, Hitesh / Zentner, Dominica / Hopper, Ingrid

    Heart, lung & circulation

    2024  

    Abstract: Background: Heart failure (HF) has high mortality and healthcare utilisation. It has a complex and unpredictable trajectory, which is often interpreted as a barrier to guideline recommended early integration of palliative care (PC). In particular, lack ... ...

    Abstract Background: Heart failure (HF) has high mortality and healthcare utilisation. It has a complex and unpredictable trajectory, which is often interpreted as a barrier to guideline recommended early integration of palliative care (PC). In particular, lack of referral criteria and misconceptions around PC affect inpatient specialist PC referrals.
    Aims: The main objective was to characterise the pattern and predictors of referral of HF patients to the specialist inpatient PC consultative service at our healthcare service.
    Methods: A retrospective, single-centre cohort study was performed on consecutive patients admitted across the hospital with HF over a 12-month period (July 2019-June 2020). Mortality data were checked against state death registry data.
    Results: The 502 patients admitted for HF were elderly (mean age 78±14 years), had high dependency (54% Australian-modified Karnofsky Performance Status (AKPS) 50-70, 29% AKPS 10-40), and high mortality (53% within median 32 months at death registry data linkage). Seven per cent (7%) were referred to inpatient specialist PC. AKPS 10-40 (62% of those referred vs 26% not referred, p<0.01), reliance on carers (65% vs 36%, p<0.01), and New York Heart Association (NYHA) class III-IV symptoms (86% vs 42%, p<0.01) were associated with referral, but two or more admissions in the last 12 months for HF were not (16% vs 10%, p=0.21). Many PC domains, such as symptom burden, distress, and preferred care, were not adequately assessed.
    Conclusions: Referral to inpatient specialist PC in hospitalised HF patients is low relative to the morbidity and mortality in these patients.
    Language English
    Publishing date 2024-03-08
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2024.01.022
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  4. Article ; Online: Comparison of Characteristics and Outcomes in Patients With Acute Decompensated Heart Failure Admitted Under General Medicine and Cardiology Units.

    Suo, Elizabeth / Driscoll, Andrea / Dinh, Diem / Brennan, Angela / Kaye, David M / Stub, Dion / Lefkovits, Jeffrey / Reid, Christopher M / Hopper, Ingrid

    Heart, lung & circulation

    2024  

    Abstract: Background: Acute decompensated heart failure (ADHF) is a leading cause of cardiovascular disease hospitalisations associated with significant morbidity and mortality. In hospitals, HF patients are typically managed by cardiology or physician teams, ... ...

    Abstract Background: Acute decompensated heart failure (ADHF) is a leading cause of cardiovascular disease hospitalisations associated with significant morbidity and mortality. In hospitals, HF patients are typically managed by cardiology or physician teams, with differences in patient demographics and clinical outcomes. This study utilises contemporary HF registry data to compare patient characteristics and outcomes in those with ADHF admitted into General Medicine and Cardiology units.
    Methods: The Victorian Cardiac Outcomes Registry was utilised to identify patients hospitalised with ADHF 30-day period in each of four consecutive years. We compared patient characteristics, pharmacological management and outpatient follow-up of patients admitted to General Medicine and Cardiology units. Primary outcome measures included in-hospital mortality, 30-day readmission, and 30-day mortality.
    Results: Between 2014 and 2017, a total of 1,253 patients with ADHF admissions were registered, with 53% admitted in General Medicine units and 47% in Cardiology units. General Medicine patients were more likely to be older (82 vs 71 years; p<0.001), female (51% vs 34%; p<0.001), and have higher prevalence of comorbidities and preserved left ventricular function (p<0.001). There were no differences in primary outcome measures between General Medicine and Cardiology in terms of: in-hospital mortality (5.0% vs 3.9%; p=0.35), 30-day readmission (23.4% vs 23.6%; p=0.93), and 30-day mortality (10.0% vs 8.0%; p=0.21).
    Conclusions: Hospitalised patients with HF continue to have high mortality and rehospitalisation rates. The choice of treatment by General Medicine or Cardiology units, based on the particular medical profile and individual needs of the patients, provides equivalent outcomes.
    Language English
    Publishing date 2024-03-07
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2024.01.016
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  5. Article: Chronic heart failure.

    Hopper, Ingrid / Easton, Kellie

    Australian prescriber

    2017  Volume 40, Issue 4, Page(s) 128–136

    Language English
    Publishing date 2017-08-01
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 1075442-8
    ISSN 0312-8008
    ISSN 0312-8008
    DOI 10.18773/austprescr.2017.044
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  6. Article ; Online: Optimising Transitional Care Following a Heart Failure Hospitalisation in Australia.

    Sindone, Andrew P / Driscoll, Andrea / Audehm, Ralph / Sverdlov, Aaron L / McVeigh, James / Alicia Chan, Wai Ping / Hickey, Annabel / Hopper, Ingrid / Chang, Tim / Maiorana, Andrew / Atherton, John J

    Heart, lung & circulation

    2024  

    Abstract: Hospitalisations for heart failure (HF) are associated with high rates of readmission and death, the most vulnerable period being within the first few weeks post-hospital discharge. Effective transition of care from hospital to community settings for ... ...

    Abstract Hospitalisations for heart failure (HF) are associated with high rates of readmission and death, the most vulnerable period being within the first few weeks post-hospital discharge. Effective transition of care from hospital to community settings for patients with HF can help reduce readmission and mortality over the vulnerable period, and improve long-term outcomes for patients, their family or carers, and the healthcare system. Planning and communication underpin a seamless transition of care, by ensuring that the changes to patients' management initiated in hospital continue to be implemented following discharge and in the long term. This evidence-based guide, developed by a multidisciplinary group of Australian experts in HF, discusses best practice for achieving appropriate and effective transition of patients hospitalised with HF to community care in the Australian setting. It provides guidance on key factors to address before and after hospital discharge, as well as practical tools that can be used to facilitate a smooth transition of care.
    Language English
    Publishing date 2024-04-30
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2023.11.029
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  7. Article: Patient Reported Outcome Measures After Breast Augmentation - Using the BREAST-Q IS.

    Jayasinghe, Randi T / Ruseckaite, Rasa / Gartoulla, Pragya / Elder, Elisabeth / Hopper, Ingrid

    Patient related outcome measures

    2022  Volume 13, Page(s) 1–8

    Abstract: Purpose: Cosmetic breast augmentation procedures are commonly performed breast device surgeries. The Australian Breast Device Registry (ABDR) administers a five-question patient reported outcome measure (PROM), the BREAST-Q Implant Surveillance module ( ... ...

    Abstract Purpose: Cosmetic breast augmentation procedures are commonly performed breast device surgeries. The Australian Breast Device Registry (ABDR) administers a five-question patient reported outcome measure (PROM), the BREAST-Q Implant Surveillance module (BREAST-Q IS), to patients 1, 2 and 5 years after breast device surgery. The measure includes an open-ended question to add any comments. This study aimed to use the responses to this open-ended question to assess participants' experiences of breast devices 1 and 2 years after breast augmentation. The secondary objective was to identify emerging and important issues relating to breast augmentation and devices.
    Patients and methods: This qualitative descriptive study was conducted using a randomly selected sample of 268 responses to the open-ended question in the BREAST-Q IS, from the ABDR database. These responses were from patients who underwent breast augmentation between 2015 and 2018. Comments were analyzed using conventional content analysis in NVivo 12.
    Results: Four major themes were identified: satisfaction following breast augmentation, dissatisfaction following breast augmentation, complications and breast symptoms following breast augmentation and other comments. Two dominant themes were regarding satisfaction (n = 112) with overall surgical outcome, medical team, and post-operative appearance and complications and breast symptoms (n = 177) following breast augmentation. Emerging issues identified were rippling of breast implants and breast implant illness (BII).
    Conclusion: PROMs can be used to understand patients' perspectives on various aspects of their own surgical experiences. Participants provided responses regarding complications and breast symptoms experienced, and rippling of the breast implants and BII are emerging issues after breast augmentation.
    Language English
    Publishing date 2022-01-11
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2586660-6
    ISSN 1179-271X
    ISSN 1179-271X
    DOI 10.2147/PROM.S330163
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  8. Article ; Online: Impact of Late Referral on Cardiac Transplant Outcomes.

    Suo, Elizabeth / Hopper, Ingrid / Tee, Su Ling / Patel, Hitesh C / Kaye, David M

    Heart, lung & circulation

    2022  Volume 31, Issue 11, Page(s) 1524–1530

    Abstract: Background: Late referral for heart transplantation (HTx) is associated with worse patient outcomes. There are no universally accepted definitions of what constitutes a timely referral for HTx assessment.: Objectives: To evaluate the impact of late ... ...

    Abstract Background: Late referral for heart transplantation (HTx) is associated with worse patient outcomes. There are no universally accepted definitions of what constitutes a timely referral for HTx assessment.
    Objectives: To evaluate the impact of late referral (LR) on HTx outcomes.
    Methods: This single-centre retrospective observational study included 80 patients undergoing HTx between 2016-2019. We applied a simple clinical tool, derived from markers of advanced heart failure (HF), to classify LR in HTx patients and assess the impact of LR on HTx outcomes. Outcome measures included duration of intensive care unit (ICU) stay, total hospitalisation stay, cost of transplant admission and one-year mortality.
    Results: Based upon the clinical profile, LR was defined by the presence of four or more out of 10 criteria for more than 6 months in HTx patients. In this model, 34 patients were timely referrals and 46 were LR. Patients who were LR had: a longer median time between initial diagnosis and referral (3 vs 7 ys; p=0.03); more features of advanced HF, including inotrope requirements (p=0.004); more comorbidities (p=0.014); and hospitalisations (p<0.0001). Late referral was not associated with longer ICU (p=0.14) or hospital stay (p=0.051), however LR incurred greater total in-hospital costs (p=0.011). There was no difference in one-year mortality (6% vs 9%; p=0.64).
    Conclusion: Patients referred late for HTx are more unwell at time of referral and require greater in-hospital resource usage at the time of transplantation. Earlier referral for transplant assessment in patients with advanced HF should be encouraged.
    MeSH term(s) Humans ; Time Factors ; Heart Transplantation ; Heart Failure/surgery ; Heart Failure/complications ; Length of Stay ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2022-08-17
    Publishing country Australia
    Document type Observational Study ; Journal Article
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2022.06.693
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  9. Article: Observational studies and their utility for practice.

    Gilmartin-Thomas, Julia Fm / Liew, Danny / Hopper, Ingrid

    Australian prescriber

    2018  Volume 41, Issue 3, Page(s) 82–85

    Language English
    Publishing date 2018-06-01
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 1075442-8
    ISSN 0312-8008
    ISSN 0312-8008
    DOI 10.18773/austprescr.2018.017
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  10. Article ; Online: Comparing Direct-to-Implant and Two-Stage Breast Reconstruction in the Australian Breast Device Registry.

    Hoque, Sheymonti S / Zhou, Jieyun / Gartoulla, Pragya / Hansen, Jessy / Farrell, Gillian / Hopper, Ingrid

    Plastic and reconstructive surgery

    2022  Volume 151, Issue 5, Page(s) 927–937

    Abstract: Background: There remains a lack of clarity surrounding the benefits, risks, and outcomes between two-stage expander/implant reconstruction and single-stage direct-to-implant (DTI) reconstruction. This study used a national data set to examine real- ... ...

    Abstract Background: There remains a lack of clarity surrounding the benefits, risks, and outcomes between two-stage expander/implant reconstruction and single-stage direct-to-implant (DTI) reconstruction. This study used a national data set to examine real-world outcomes of two-stage and DTI reconstructions.
    Methods: A cohort study was conducted examining patients in the Australian Breast Device Registry (ABDR) from 2015 to 2018 who underwent prosthetic breast reconstruction following mastectomy. DTI and two-stage cohorts after definitive implant insertion were compared. Rate of revision surgery, reasons for revision, and patient-reported outcome measures were recorded. Statistical analysis was undertaken using Fisher exact or chi-square, Wilcoxon rank sum, or t tests; Nelson-Aalen cumulative incidence estimates; and Cox proportional hazards regression.
    Results: A total of 5152 breast reconstructions were recorded, including 3093 two-stage and 2059 DTI reconstructions. Overall revision surgery rates were 15.6% for DTI (median follow-up, 24.7 months), compared with 9.7% in the two-stage cohort (median follow-up, 26.5 months; P < 0.001). The most common reasons for revision for DTI and two-stage reconstruction were capsular contracture (25.2% versus 26.7%; P = 0.714) and implant malposition (26.7% versus 34.3%; P = 0.045). Multivariate analysis found acellular dermal matrix use ( P = 0.028) was significantly associated with a higher risk of revision. The influence of radiotherapy on revision rates was unable to be studied. Patient satisfaction levels were similar between reconstructive groups; however, patient experience was better in the DTI cohort than in the two-stage cohort.
    Conclusions: The ABDR data set demonstrated that DTI reconstruction had a higher revision rate than two-stage, but with comparable patient satisfaction and better patient experience. Capsular contracture and device malposition were leading causes of revision in both cohorts.
    Clinical question/level of evidence: Therapeutic, III.
    MeSH term(s) Female ; Humans ; Australia ; Breast Implantation/adverse effects ; Breast Implants/adverse effects ; Breast Neoplasms/surgery ; Cohort Studies ; Contracture ; Mammaplasty ; Mastectomy/adverse effects ; Registries ; Retrospective Studies ; Tissue Expansion Devices ; Treatment Outcome
    Language English
    Publishing date 2022-12-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000010066
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