PubMed Health⌕ Search

Biomedical subjects

M Schousboe

Publications and source records attributed to M Schousboe.

15 recordsLinked to original sources
PubMed2002

Cost-effectiveness of palivizumab in New Zealand.

OBJECTIVE: To establish the preterm infant hospitalization risks from respiratory syncytial virus (RSV) in New Zealand and the net cost per hospitalization averted by palivizumab. METHODS: The 437 infants born < 32 weeks' gestation in 1997 and treated at five major neonatal units were identified. Subsequent admissions during the next 2 years for bronchiolitis, pneumonia and croup were tracked, and information collected on RSV tests performed. Data on the length of stay and hospital costs were used to calculate the potential net cost per hospitalization averted associated with the use of palivizumab and the number needed to treat (NNT) to prevent one hospitalization. RESULTS: Estimated RSV readmission risk before 1 year corrected age in infants < 32 weeks' gestation discharged home on oxygen, and those " 28 weeks' gestation, or between 29 and 31 weeks' gestation with or without chronic lung disease was 42%, 23%, 19%, 10% and 8%, respectively. The NNT with palivizumab to prevent one hospitalization ranged from six to 26 across subgroups. Mean (range) net cost per hospitalization averted was 60,000 New Zealand dollars ($28,000-$166,700). In no subgroup would prophylaxis result in net cost saving. Prophylaxis for all NZ infants " 28 weeks' gestation would cost approximately $1,090,000 net and prevent 29 hospitalizations annually, being equivalent to $37,000 net per hospitalization averted, with eight infants treated to prevent one hospitalization. Alternative assumptions about cost and efficacy failed to alter these findings. CONCLUSION: If value is placed on preventing morbidity, the priority groups for palivizumab prophylaxis are preterm infants discharged home on oxygen, followed by preterm infants of 28 weeks' gestation or less.

Antibodies, Monoclonal↗
PubMed1999

Trends in hospitalization and mortality from rotavirus disease in New Zealand infants.

BACKGROUND: Rotavirus illness is associated with significant morbidity and mortality worldwide. We have examined trends in diarrheal disease in New Zealand children to determine the disease burden attributable to rotavirus and to estimate the proportion of hospitalizations preventable by vaccination. METHODS: Hospital admissions data and laboratory records for 1994 to 1996, were obtained for children 0 to 4 years at four sites (serving -60% of the New Zealand population). Rotavirus disease burden was estimated using combined admissions and laboratory data. Severity of disease was estimated in a sample of 150 hospitalizations for rotavirus diarrhea, and the proportion of vaccine-preventable admissions was extrapolated. Mortality attributed to diarrheal causes was determined from national records for 1974 to 1993. RESULTS: Between 1994 and 1996, 4436 children <5 years of age were hospitalized with diarrhea (1047/100000 children per year). Admissions associated with rotavirus were estimated at 1522 to 1535 (315 to 362/100000 annually). Infants between 6 and 17 months were most commonly affected (42% of all cases). More male children than female children were hospitalized (P < 0.001) and mean length of stay was calculated as 1.51 days (SD 2.35). Disease severity scoring revealed that 61.3 and 38.0% of admissions reviewed were severe and very severe, respectively. Deaths from diarrheal causes numbered 138 among children 0 to 4 years old for the 20-year period 1974 to 1993, with 18 deaths occurring between 1984 and 1993 (10 years). CONCLUSION: Current vaccines control severe disease, suggesting that 72% of cases reviewed would be eligible for prevention. A full cost effectiveness analysis is required to demonstrate anticipated benefits of vaccination.

Child, Preschool↗
PubMed1996

Community acquired pneumonia: aetiology and usefulness of severity criteria on admission.

BACKGROUND: Community acquired pneumonia remains an important cause of hospital admission and carries an appreciable mortality. Criteria for the assessment of severity during admission have been developed by the British Thoracic Society (BTS). A study was performed to determine the sensitivity and specificity of a severity rule based on a modification of the BTS prognostic rules applied on admission, to compare severity as assessed by medical staff with the modified rule, and to determine the microbiological cause of community acquired pneumonia in Christchurch. METHODS: A 12 month study of all adults admitted to Christchurch Hospital with community acquired pneumonia was undertaken. Three hundred and sixteen consecutive patients with suspected community acquired pneumonia were screened for inclusion. Variables obtained from the history, examination, investigations, and initial treatment were examined for association with mortality. RESULTS: Two hundred and fifty five patients met the inclusion criteria. Their mean age was 58 years (range 18-97). A microbiological diagnosis was made in 181 cases (71%), Streptococcus pneumonia (39%), Mycoplasma pneumoniae (16%), Legionella species (11%), and Haemophilus influenzae (11%) being the most commonly identified organisms. Patients had a 36-fold increased risk of death if any two of the following were present on admission: respiratory rate > or = 30/min, diastolic BP < or = 60 mm Hg, urea > 7 mmol/l, or confusion. The severity rule identified 19 of the 20 patients who died and six of eight patients admitted to the intensive care unit as having life threatening community acquired pneumonia. The sensitivity of the modified rule for predicting death was 0.95 and the specificity 0.71. In 47 cases (21%) the clinical team appeared to underestimate the severity of the illness. CONCLUSIONS: The organisms responsible for community acquired pneumonia in Christchurch are similar to those reported from other centres except for Legionella species which were more common than in most studies. The modification of the BTS prognostic rules applied as a severity indicator at admission performed well and could be incorporated into management guidelines.

Adolescent↗
PubMed1986

Peritonsillar infection in Christchurch 1981-1984.

Retrospective review of the notes of 83 peritonsillar infection sufferers over three years at Christchurch Hospital reveals that the typical sufferer is a young adult male who is most likely to present in winter or summer. Only a quarter of the patients had a significant recent history of tonsillitis but four had had a previous quinsy and six had had a previous tonsillectomy in childhood. Length of symptoms does not appear helpful in differentiating an abscess from a cellulitis. Anaerobic organisms were found in 49% of aspirates and streptococci were the most important aerobic organism. Potential beta lactamase producing organisms, H influenzae, Staph aureus and Bacteroides sp were infrequent and penicillin remains the drug of choice. Appropriate antibiotics and drainage are the essentials of management and tonsillectomy may be indicated.

Adolescent↗
PubMed1985

Listeriosis in Christchurch 1967-1984.

Between February 1981-May 1982, 18 Christchurch patients were infected with Listeria monocytogenes. Of these eight were pregnant, and three mid-trimester abortions and one neonatal death occurred in this group. One death due to listeriosis occurred amongst the other ten patients. Three patients were part of a small nosocomial outbreak. Prior to February 1981 and since May 1982, infections caused by this organism have been very uncommon. The possible sources of the organism are discussed.

Abortion, Spontaneous↗
PubMed1980

Endoscopic retrograde cholangio-pancreatography: related nosocomial infections.

The flexible endoscopes of a gastroenterology department were microbiologically examined after one patient developed a possible nosocomial infection. The endoscopes were found to be contaminated by pseudomonas species. An appropriate cleaning regime was developed and the initial difficulties in sterilising the instruments are described. The medical records of all ERCPed patients for the one and half years prior to and the half year after the monitoring exercise were examined. It was found that approximately 50 percent of patients examined in the half year prior to the introduction of endoscopic monitoring had infections with Pseudomonas species.

Cholangiopancreatography, Endoscopic Retrograde↗