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Trauma-related admissions to intensive care units in Australia: the influence of Indigenous status on outcomes.
Med J Aust. 2019 06; 210(11):493-498.MJ

Abstract

OBJECTIVES

To investigate the admission characteristics and hospital outcomes for Indigenous and non-Indigenous patients admitted to intensive units (ICUs) after major trauma.

DESIGN, SETTING

Retrospective analysis of Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database data from 92 Australian ICUs for the 6-year period, 2010-2015.

PARTICIPANTS

Patients older than 17 years of age admitted to public hospital ICUs 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 ICUs 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.

Authors+Show Affiliations

Alfred Hospital, Melbourne, VIC.Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.Monash University, Melbourne, VIC.Alfred Hospital, Melbourne, VIC. Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, VIC.Monash University, Melbourne, VIC. Alice Springs Hospital, Alice Springs, NT.Wellington Hospital, Wellington, New Zealand.Austin Hospital, Melbourne, VIC.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

30644562

Citation

Magee, Fraser, et al. "Trauma-related Admissions to Intensive Care Units in Australia: the Influence of Indigenous Status On Outcomes." The Medical Journal of Australia, vol. 210, no. 11, 2019, pp. 493-498.
Magee F, Wilson A, Bailey MJ, et al. Trauma-related admissions to intensive care units in Australia: the influence of Indigenous status on outcomes. Med J Aust. 2019;210(11):493-498.
Magee, F., Wilson, A., Bailey, M. J., Pilcher, D., Secombe, P. J., Young, P., & Bellomo, R. (2019). Trauma-related admissions to intensive care units in Australia: the influence of Indigenous status on outcomes. The Medical Journal of Australia, 210(11), 493-498. https://doi.org/10.5694/mja2.12028
Magee F, et al. Trauma-related Admissions to Intensive Care Units in Australia: the Influence of Indigenous Status On Outcomes. Med J Aust. 2019;210(11):493-498. PubMed PMID: 30644562.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trauma-related admissions to intensive care units in Australia: the influence of Indigenous status on outcomes. AU - Magee,Fraser, AU - Wilson,Anthony, AU - Bailey,Michael J, AU - Pilcher,David, AU - Secombe,Paul J, AU - Young,Paul, AU - Bellomo,Rinaldo, Y1 - 2018/12/07/ PY - 2018/04/10/received PY - 2018/07/11/accepted PY - 2019/1/16/pubmed PY - 2020/1/23/medline PY - 2019/1/16/entrez KW - Intensive care KW - Trauma surgery SP - 493 EP - 498 JF - The Medical journal of Australia JO - Med J Aust VL - 210 IS - 11 N2 - OBJECTIVES: To investigate the admission characteristics and hospital outcomes for Indigenous and non-Indigenous patients admitted to intensive units (ICUs) after major trauma. DESIGN, SETTING: Retrospective analysis of Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database data from 92 Australian ICUs for the 6-year period, 2010-2015. PARTICIPANTS: Patients older than 17 years of age admitted to public hospital ICUs 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 ICUs 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. SN - 1326-5377 UR - https://www.unboundmedicine.com/medline/citation/30644562/Trauma_related_admissions_to_intensive_care_units_in_Australia:_the_influence_of_Indigenous_status_on_outcomes_ L2 - https://doi.org/10.5694/mja2.12028 DB - PRIME DP - Unbound Medicine ER -