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

C2 - 30644562

AN - SCOPUS:85066032992

VL - 210

SP - 493

EP - 498

JO - Medical Journal of Australia

JF - Medical Journal of Australia

SN - 0025-729X

IS - 11

ER -