Trauma-related admissions to intensive care units in Australia

the influence of Indigenous status on outcomes

Fraser Magee, Anthony Wilson, Michael J. Bailey, David Pilcher, Paul J. Secombe, Paul Young, Rinaldo Bellomo

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)493-498
Number of pages6
JournalMedical Journal of Australia
Volume210
Issue number11
DOIs
Publication statusPublished - Jun 2019

Keywords

  • Intensive care
  • Trauma surgery

Cite this

@article{e62f7ef0b83b478484c7a36d88ea0eae,
title = "Trauma-related admissions to intensive care units in Australia: the influence of Indigenous status on outcomes",
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.",
keywords = "Intensive care, Trauma surgery",
author = "Fraser Magee and Anthony Wilson and Bailey, {Michael J.} and David Pilcher and Secombe, {Paul J.} and Paul Young and Rinaldo Bellomo",
year = "2019",
month = "6",
doi = "10.5694/mja2.12028",
language = "English",
volume = "210",
pages = "493--498",
journal = "Medical Journal of Australia",
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}

Trauma-related admissions to intensive care units in Australia : the influence of Indigenous status on outcomes. / Magee, Fraser; Wilson, Anthony; Bailey, Michael J.; Pilcher, David; Secombe, Paul J.; Young, Paul; Bellomo, Rinaldo.

In: Medical Journal of Australia, Vol. 210, No. 11, 06.2019, p. 493-498.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Trauma-related admissions to intensive care units in Australia

T2 - 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

PY - 2019/6

Y1 - 2019/6

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.

AB - 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.

KW - Intensive care

KW - Trauma surgery

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U2 - 10.5694/mja2.12028

DO - 10.5694/mja2.12028

M3 - Article

VL - 210

SP - 493

EP - 498

JO - Medical Journal of Australia

JF - Medical Journal of Australia

SN - 0025-729X

IS - 11

ER -