Post-operative risk factor control following internal carotid artery intervention.

BACKGROUND: Patients who undergo carotid surgical interventions remain at significant risk of further vascular events post-operatively. This study evaluates the level of risk factor monitoring and control being achieved post-operatively for patients who undergo carotid surgical interventions within Southern Health and investigates the significance of patient education and patient insight in this context. METHODS: The study included all patients who underwent successful carotid endarterectomy (CEA) or carotid angioplasty within Southern Health during the 5-year study period. To ascertain the objective risk factor status of participants, the most current reported measurements for the variables of blood pressure, blood lipids and glycosylated hemoglobin were obtained from the participant's usual medical attendants. To ascertain the participant's subjective perceptions of their risk factor status, participants completed a self-administered mail-out questionnaire. RESULTS: A high level of post-operative risk factor monitoring was demonstrated. Post-operative risk factor control was not as commendable. There was a significant discrepancy identified between patient perceptions of current post-operative risk factor status and the objective reality of current post-operative risk factor status. There was a moderate positive linear correlation between level of accurate patient insight into their disease (including their post-operative risk factor control) and the level of postoperative risk factor control being achieved (r = 0.51, P <0.001). CONCLUSION: Future strategy targeted at achieving optimal post-CEA and carotid angioplasty with adjuvant stenting risk factor control should consider incorporating themes that increase the level of accurate patient insight into their disease (particularly their post-operative risk factor control), for instance, patient education and effective doctor-patient communication.

Hospital-admitted eye injury in Victoria, Australia.

BACKGROUND: The public health concern represented by eye injury in Victoria, Australia has been known for a period now approaching 20 years. However, there has been no improvement observed in this public health concern since it was first identified in the 1990s. This study further investigates the epidemiology of eye injury in Victoria, specifically hospital-admitted eye injury. METHODS: The Victorian Admitted Episodes Dataset was surveyed for eye injury coded by the International Classification of Diseases 10th revision during the period spanning 2001-2005, retrieving all cases of hospital-admitted eye injury in Victoria during the surveyed period. RESULTS: During the period surveyed, the average incidence of eye injury requiring hospital admission in Victoria was 53.6 per 100 000 person-years. Sixty-four per cent of patients were male and 36% were female (P < 0.001). Male patients were most commonly middle-aged compared with female patients who were most commonly middle-aged to elderly (P < 0.001). Core patient groups included: elderly women sustaining eye injuries as a result of falls (particularly in residential homes); middle-aged men sustaining eye injuries as a result of assault and in transport-related accidents. CONCLUSION: The incidence of hospital-admitted eye injury in Victoria has increased since it was first identified as a concern in the 1990s. The design and implementation of an effective preventative strategy to reduce the rate of hospital-admitted eye injury in Victoria presents as a difficult task given that the most common causes are represented by falls, assault and transport-related accidents.