Graeme J Duke

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Despite reports showing night discharge from an intensive care unit (ICU) is associated with increased mortality, it is unknown if this has resulted in changes in practice in recent years. Our aim was to determine prevalence, trends and effect on patient outcome of discharge timing from ICU throughout Australia and New Zealand. Two datasets from the(More)
We compared the performance of six outcome prediction models--three based on 24-hour data and three based on admission-only data--in a metropolitan university-affiliated teaching hospital with a 10-bed intensive care unit. The Acute Physiology and Chronic Health Evaluation models, version II (APACHE II) and version III-J, and the Simplified Acute Physiology(More)
UNLABELLED Intensive Care (ICU) survivors discharged from ICU to the general ward at night have a higher mortality. We sought to clarify which factors, including night-shift discharge, influence outcome following ICU discharge in a metropolitan hospital, using a cohort study of critically-ill patients between 1/1/1999-30/4/2003. Patients were excluded from(More)
OBJECTIVE Low-dose dopamine has been used in critically ill patients to minimize renal dysfunction without sufficient data to support its use. The aim of this study was to determine whether low-dose dopamine improves renal function, and whether dobutamine, a nondopaminergic inotrope, improves renal function. DESIGN Prospective, randomized, double-blind(More)
This review describes the methods for displaying riskadjusted mortality data for critical care units. Two applications are considered. The comparison within a cohort of risk-adjusted mortality performance uses standardised mortality ratios (SMRs), league tables, caterpillar plots and funnel plots. Monitoring of riskadjusted performance over time is(More)
We present the first six cases of H1N1 influenza 09 (confirmed by a polymerase chain reaction test from nasopharyngeal swabs) in patients requiring admission to intensive care in Australia (in three hospitals in the north-western suburbs of Melbourne). These cases highlight the small but significant risk of life-threatening respiratory failure associated(More)
RATIONALE Previous studies suggested an association between after-hours intensive care unit (ICU) discharge and increased hospital mortality. Their retrospective design and lack of correction for patient factors present at the time of discharge make this association problematic. OBJECTIVES To determine factors independently associated with mortality after(More)
OBJECTIVE To evaluate the management of severe trauma in intensive care, high dependency and general surgical wards of Victorian hospitals. DESIGN Retrospective case review by multidisciplinary committees. SUBJECTS The first 256 people who died from road traffic accidents who were alive on the arrival of emergency services between 1 July 1992 and 30(More)
BACKGROUND The aim of this study was to validate a risk-adjusted hospital outcome prediction equation (HOPE) using a statewide administrative dataset. METHODS Retrospective observational study using multivariate logistic regression modelling. Calibration and discrimination were assessed by standardized mortality ratio (SMR), area under the receiver(More)
OBJECTIVE To quantify the morbidity and mortality associated with acute interhospital transfer of critically ill patients requiring intensive care (ICU) services. DESIGN Three-year (1 July 1996-30 June 1999) retrospective case-control study based on review of patients' medical records. SETTING Metropolitan hospitals in Melbourne, Victoria. (More)