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Trauma‐related admissions to intensive care units in Australia: the influence of Indigenous status on outcomes
Author(s) -
Magee Fraser,
Wilson Anthony,
Bailey Michael J,
Pilcher David,
Secombe Paul J,
Young Paul,
Bellomo Rinaldo
Publication year - 2019
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja2.12028
Subject(s) - indigenous , medicine , incidence (geometry) , population , odds ratio , intensive care , emergency medicine , mortality rate , retrospective cohort study , intensive care unit , epidemiology , demography , intensive care medicine , environmental health , surgery , ecology , physics , sociology , optics , biology
Objectives To investigate the admission characteristics and hospital outcomes for Indigenous and non‐Indigenous patients admitted to intensive units ( ICU s) after major trauma. Design, setting Retrospective analysis of Australian and New Zealand Intensive Care Society ( ANZICS ) Adult Patient Database data from 92 Australian ICU s for the 6‐year period, 2010–2015. Participants Patients older than 17 years of age admitted to public hospital ICU s with a primary diagnosis of trauma. Main outcome measures ICU and overall hospital lengths of stay, hospital discharge destination, and ICU and overall hospital mortality rates for Indigenous and non‐Indigenous patients. Results 23 804 people were admitted to Australian public hospital ICU s after major trauma; 1754 (7.4%) were Indigenous Australians. The population‐standardised incidence of admissions was consistently higher for Indigenous Australians than for non‐Indigenous Australians (847 per million v 251 per million population; incidence ratio, 3.37; 95% CI , 3.19–3.57). Overall hospital mortality rates were similar for Indigenous and non‐Indigenous patients (adjusted odds ratio [ aOR ], 1.04; 95% CI , 0.82–1.31). Indigenous patients were more likely than non‐Indigenous patients to be discharged to another hospital (non‐Indigenous v Indigenous: aOR , 0.84; 95% CI , 0.72–0.96) less likely to be discharged home (non‐Indigenous v Indigenous: aOR , 1.17; 95% CI , 1.04–1.31). Conclusion The population rate of trauma‐related ICU admissions was substantially higher for Indigenous than non‐Indigenous patients, but hospital mortality rates after ICU admission were similar. Indigenous patients were more likely to be discharged to a another hospital and less likely to be discharged home than non‐Indigenous patients.