OPERA Score – Risk Stratification in Older Adults Admitted to Hospital
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248477 Demographic changes alongside medical advances have resulted in older adults accounting for an increasing proportion of emergency hospital admissions. Current measures of illness severity, limited to physiological parameters, have shortcomings in this cohort, partly due to patient complexity. This study aimed to derive and validate a risk score for acutely unwell older adults which […]
Ongoing COVID-19 Rehab Research
Technology supported rehabilitation for patients of critical illness caused by COVID-19: a protocol for a mixed-methods feasibility study The COVID-19 pandemic has created the need for research on how to effectively rehabilitate patients who have been discharged from an intensive care unit. This study is a protocol for a mixed methods feasibility study addressing the […]
One way to get patients back on their feet after COVID19 infection
Socially distanced rehabilitation supported by technology: a potential new normal for post-ITU deconditioning? Posted on August 7, 2020 by BJSM One way to get patients back on their feet after COVID19 infection Coronavirus disease 2019 (COVID-19) has dramatically affected global society and it is unclear when its effects will subside. There have been over 500,000 deaths and 13.5 million […]
Frailty Assessment
Meeting the needs of an ageing society is one of the Governments’ ‘Grand Challenges.’ In coastal West Sussex, 25% of the population are over 65, a statistic England overall is projected to reflect by 2035. Emergency departments (EDs) have experienced increased attendances of older people and delivery of high quality, holistic care requires accurate screening […]
Hip Fracture Management
Outcomes Worthing and Chichester Hospitals manage over 900 hip fractures a year. Though partly through the work of the national hip fracture audit outcomes have been improving over the last decade, this group are still at high risk of short and longer-term mortality and complications and spend a significant amount of time in the hospital. […]
Emergency Department Crowding
Emergency department (ED) crowding has significant adverse consequences, however, there is no widely accepted tool to measure it. In a prospective study involving ED nurses and clinicians we validated the National Emergency Department Overcrowding score (NEDOCS) which uses routinely collected ED data. This work was presented in Prague at EUSEM and published in the EMJ: […]
Liver disease
Acute hepatic dysfunction in the critically ill population with pre-existing liver cirrhosis is associated with a high mortality. Several prediction models have been developed to risk stratify patients with liver disease. In a dual-centre study we validated a recently described model against other prediction models and described long-term outcomes of the cohort. This work was […]
Sodium Bicarbonate in AKI
As part of a National team we will be investigating the use of sodium bicarbonate in a multi-centre randomised controlled trial beginning in 2021 funded through the NIHR HTA. Around 184,000 critically ill adults are admitted to critical care units each year in the UK. Around half have a sudden worsening in kidney function that […]
ICE-AKI Study
Background: Acute kidney injury (AKI) is assoicated with high mortality and measures to improve risk stratification and early identification have been urgently called for. This study investigated whether an electronic clinical prediction rule (CPR) combined with an AKI e-alert could reduce hospital-acquired AKI (HA-AKI) and improve associated outcomes. Methods and findings: A controlled before-and-after study included 30,295 […]
Critical Thinking Begins
Critical care is changing. The particular demand for specialised high end care is increasing and will continue to increase in the future. The COVID-19 pandemic has strained the existing critical care resources and encouraged spending to increase the capacity of care beyond that which was possible before. Respiratory viruses not only target our individual physiological […]