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Ibrahim LF, Tham D, Chong V, Corden M, Craig S, Buntine P, Jani S, Zhang M, George S, Kochar A, O'Brien S, Robins-Browne K, Tosif S, Daley A, McNab S, Crawford NW, Wilson C, Babl FE. The characteristics of SARS-CoV-2-positive children who presented to Australian hospitals during 2020: a PREDICT network study. Med J Aust 2021; 215:217-221. [PMID: 34389995 PMCID: PMC8447363 DOI: 10.5694/mja2.51207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To examine the epidemiological and clinical characteristics of SARS-CoV-2-positive children in Australia during 2020. DESIGN, SETTING Multicentre retrospective study in 16 hospitals of the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network; eleven in Victoria, five in four other Australian states. PARTICIPANTS Children aged 0-17 years who presented to hospital-based COVID-19 testing clinics, hospital wards, or emergency departments during 1 February - 30 September 2020 and who were positive for SARS-CoV-2. MAIN OUTCOME MEASURES Epidemiological and clinical characteristics of children positive for SARS-CoV-2. RESULTS A total of 393 SARS-CoV-2-positive children (181 girls, 46%) presented to the participating hospitals (426 presentations, including 131 to emergency departments [31%]), the first on 3 February 2020. Thirty-three children presented more than once (8%), including two who were transferred to participating tertiary centres (0.5%). The median age of the children was 5.3 years (IQR, 1.9-12.0 years; range, 10 days to 17.9 years). Hospital admissions followed 51 of 426 presentations (12%; 44 children), including 17 patients who were managed remotely by hospital in the home. Only 16 of the 426 presentations led to hospital medical interventions (4%). Two children (0.5%) were diagnosed with the paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). CONCLUSION The clinical course for most SARS-CoV-2-positive children who presented to Australian hospitals was mild, and did not require medical intervention.
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Affiliation(s)
- Laila F Ibrahim
- Murdoch Children's Research Institute, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Doris Tham
- Murdoch Children's Research Institute, Melbourne, VIC.,Western Health, Melbourne, VIC
| | | | | | - Simon Craig
- Monash Health, Melbourne, VIC.,Monash University, Melbourne, VIC
| | - Paul Buntine
- Eastern Health, Melbourne, VIC.,Box Hill Hospital, Melbourne, VIC
| | - Shefali Jani
- The Children's Hospital at Westmead, Sydney, NSW.,The University of Sydney, Sydney, NSW
| | | | - Shane George
- Gold Coast University Hospital, Gold Coast, QLD.,The University of Queensland Child Health Research Centre, Brisbane, QLD
| | - Amit Kochar
- Women's and Children's Hospital, Adelaide, SA
| | - Sharon O'Brien
- Perth Children's Hospital, Perth, WA.,Curtin University, Perth, WA
| | | | - Shidan Tosif
- Murdoch Children's Research Institute, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Andrew Daley
- Murdoch Children's Research Institute, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Sarah McNab
- Murdoch Children's Research Institute, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Nigel W Crawford
- Murdoch Children's Research Institute, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | | | - Franz E Babl
- Murdoch Children's Research Institute, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
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Wilson CL, Tavender EJ, Phillips NT, Hearps SJC, Foster K, O'Brien SL, Borland ML, Watkins GO, McLeod L, Putland M, Priestley S, Brabyn C, Ballard DW, Craig S, Dalziel SR, Oakley E, Babl FE. Variation in CT use for paediatric head injuries across different types of emergency departments in Australia and New Zealand. Emerg Med J 2020; 37:686-689. [DOI: 10.1136/emermed-2020-209719] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 11/04/2022]
Abstract
ObjectivesCT of the brain (CTB) for paediatric head injury is used less frequently at tertiary paediatric emergency departments (EDs) in Australia and New Zealand than in North America. In preparation for release of a national head injury guideline and given the high variation in CTB use found in North America, we aimed to assess variation in CTB use for paediatric head injury across hospitals types.MethodsMulticentre retrospective review of presentations to tertiary, urban/suburban and regional/rural EDs in Australia and New Zealand in 2016. Children aged <16 years, with a primary ED diagnosis of head injury were included and data extracted from 100 eligible cases per site. Primary outcome was CTB use adjusted for severity (Glasgow Coma Scale) with 95% CIs; secondary outcomes included hospital length of stay and admission rate.ResultsThere were 3072 head injury presentations at 31 EDs: 9 tertiary (n=900), 11 urban/suburban (n=1072) and 11 regional/rural EDs (n=1100). The proportion of children with Glasgow Coma Score ≤13 was 1.3% in each type of hospital. Among all presentations, CTB was performed for 8.2% (95% CI 6.4 to 10.0) in tertiary hospitals, 6.6% (95% CI 5.1 to 8.1) in urban/suburban hospitals and 6.1% (95% CI 4.7 to 7.5) in regional/rural. Intragroup variation of CTB use ranged from 0% to 14%. The regional/rural hospitals admitted fewer patients (14.6%, 95% CI 12.6% to 16.9%, p<0.001) than tertiary and urban/suburban hospitals (28.1%, 95% CI 25.2% to 31.2%; 27.3%, 95% CI 24.7% to 30.1%).ConclusionsIn Australia and New Zealand, there was no difference in CTB use for paediatric patients with head injuries across tertiary, urban/suburban and regional/rural EDs with similar intragroup variation. This information can inform a binational head injury guideline.
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Sweeny A, van den Berg L, Hocking J, Renaud J, Young S, Henshaw R, Foster K, Howell T. A Queensland research support network in emergency healthcare. J Health Organ Manag 2019; 33:93-109. [PMID: 30859915 DOI: 10.1108/jhom-02-2018-0068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to describe the structure and impact of a Queensland Research Support Network (RSN) in emergency medicine (EM). DESIGN/METHODOLOGY/APPROACH This paper presents a descriptive summary of EM networks, network evaluations and the structure and development of the Emergency Medicine Foundation's (EMF) RSN in Queensland, including an observational pre- and post-study of research metrics. FINDINGS In two years, the RSN supported 33 Queensland emergency departments (EDs), of which 14 developed research strategies. There was an increase in research active clinicians, from 23 in 2015 to 181 in 2017. Collaborator engagement increased from 9 in 2015 to 276 in 2017 as did the number of research presentations, from 6 in 2015 to 61 in 2017. EMF experienced a growth in new researchers, with new investigators submitting approximately 60 per cent of grant applications in 2016 and 2017. EMF also received new applications from a further three HHS (taking EMF-funded research activity from 8 to 11 HHS). RESEARCH LIMITATIONS/IMPLICATIONS This paper describes changes in KPIs and research metrics, which the authors attribute to the establishment of the RSN. However, it is possible that attribution bias plays a role in the KPI improvements. SOCIAL IMPLICATIONS This network has actively boosted and expanded EM research capacity and capability in Queensland. It provides services, in the form of on-the-ground managers, to develop novice clinician-researchers, new projects and engage entire EDs. This model may be replicated nationwide but requires funding commitment. ORIGINALITY/VALUE The RSN improves front-line clinician research capacity and capability and increases research activity and collaborations with clear community outcomes. Collaborations were extended to community, primary health networks, non-government organisations, national and international researchers and academic institutions. Evaluating and measuring a network's benefits are difficult, but it is likely that evaluations will help networks obtain funding.
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Affiliation(s)
- Amy Sweeny
- Emergency Department, Gold Coast University Hospital , Southport, Australia
| | | | - Julia Hocking
- Emergency Medicine Foundation Ltd, Brisbane, Australia.,Queensland University of Technology , Brisbane, Australia
| | - Julia Renaud
- Emergency Medicine Foundation Ltd, Brisbane, Australia
| | - Sharleen Young
- West Moreton Hospital and Health Service, Ipswich, Australia
| | - Richard Henshaw
- Darling Downs Hospital and Health Service, Toowoomba, Australia
| | - Kelly Foster
- Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Tegwen Howell
- Emergency Medicine Foundation Ltd, Brisbane, Australia
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Abstract
OBJECTIVE The objective of the study was to describe the origins, growth, and progress of a national research network in pediatric emergency medicine. METHODS The success of Pediatric Emergency Research Canada (PERC) is described in terms of advancing the pediatric emergency medicine agenda, grant funding, peer-reviewed publications, mentoring new investigators, and global collaborations. RESULTS Since 1995, clinicians and investigators within PERC have grown the network to 15 active tertiary pediatric emergency medicine sites across Canada. Investigators have advanced the research agenda in numerous areas, including gastroenteritis, bronchiolitis, croup, head injury, asthma, and injury management. Since the first PERC Annual Scientific meeting in 2004, the attendance has increased by approximately 400% to 152 attendees, 65 presentations, and 13 project/investigator meetings. More than $33 million in grant funding has been awarded to the network, and has published 76 peer-reviewed articles. In 2011, PERC's success was recognized with a Top Achievement Award in Health Research from Canadian Institutes of Health Research and the Canadian Medical Association Journal. CONCLUSIONS Moving forward, PERC will continue to focus on the creation of new knowledge, the mentorship of new investigators and fellows in developing research projects, and promoting a pediatric emergency medicine-focused research agenda guided by the pooling of expertise from individuals across the nation. Through collaborations with networks across the globe, PERC will continue to strive for the conduct of high-quality, impactful research that improves outcomes in children with acute illness and injury.
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