Long term outcomes for Aboriginal and Torres Strait Islander Australians after hospital intensive care

William G Mitchell; Adam Deane; Alex Brown; Shailesh Bihari; Hao Wong; Rajaram Ramadoss; Mark Finnis

doi:10.5694/mja2.50649

Long term outcomes for Aboriginal and Torres Strait Islander Australians after hospital intensive care

William G Mitchell, Adam Deane, Alex Brown, Shailesh Bihari, Hao Wong, Rajaram Ramadoss, Mark Finnis

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

OBJECTIVES: To assess long term outcomes for Aboriginal and Torres Strait Islander (Indigenous) Australians admitted non-electively to intensive care units (ICUs).

DESIGN: Data linkage cohort study; analysis of ICU patient data (Australian and New Zealand Intensive Care Society Adult Patient Database), prospectively collected during 2007-2016.

SETTING: All four university-affiliated level 3 ICUs in South Australia.

MAIN OUTCOMES: Mortality (in-hospital, and 12 months and 8 years after admission to ICU), by Indigenous status.

RESULTS: 2035 of 39 784 non-elective index ICU admissions (5.1%) were of Indigenous Australians, including 1461 of 37 661 patients with South Australian residential postcodes. The median age of Indigenous patients (45 years; IQR, 34-57 years) was lower than for non-Indigenous ICU patients (64 years; IQR, 47-76 years). For patients with South Australian postcodes, unadjusted mortality at discharge and 12 months and 8 years after admission was lower for Indigenous patients; after adjusting for age, sex, diabetes, severity of illness, and diagnostic group, mortality was similar for both groups at discharge (adjusted odds ratio [aOR], 0.95; 95% CI, 0.81-1.10), but greater for Indigenous patients at 12 months (aOR, 1.14; 95% CI, 1.03-1.26) and 8 years (adjusted hazard ratio, 1.23; 95% CI, 1.13-1.35). The number of potential years of life lost was greater for Indigenous patients (median, 24.0; IQR, 15.8-31.8 v 12.5; IQR, 0-22.3), but, referenced to respective population life expectancies, relative survival at 8 years was similar (proportions: Indigenous, 0.78; 95% CI, 0.75-0.80; non-Indigenous, 0.77; 95% CI, 0.76-0.78).

CONCLUSIONS: Adjusted long term mortality and median number of potential life years lost are higher for Indigenous than non-Indigenous patients after intensive care in hospital. These differences reflect underlying population survival patterns rather than the effects of ICU admission.

Original language	English
Pages (from-to)	16-21
Number of pages	6
Journal	The Medical journal of Australia
Volume	213
Issue number	1
DOIs	https://doi.org/10.5694/mja2.50649
Publication status	Published or Issued - 2 Jun 2020
Externally published	Yes

Keywords

Aboriginal and Torres Strait islander Australians
intensive care units
Long term
outcomes

Access to Document

10.5694/mja2.50649

Cite this

@article{87ba3c7618cc430d952210e9af144206,

title = "Long term outcomes for Aboriginal and Torres Strait Islander Australians after hospital intensive care",

abstract = "OBJECTIVES: To assess long term outcomes for Aboriginal and Torres Strait Islander (Indigenous) Australians admitted non-electively to intensive care units (ICUs).DESIGN: Data linkage cohort study; analysis of ICU patient data (Australian and New Zealand Intensive Care Society Adult Patient Database), prospectively collected during 2007-2016.SETTING: All four university-affiliated level 3 ICUs in South Australia.MAIN OUTCOMES: Mortality (in-hospital, and 12 months and 8 years after admission to ICU), by Indigenous status.RESULTS: 2035 of 39 784 non-elective index ICU admissions (5.1%) were of Indigenous Australians, including 1461 of 37 661 patients with South Australian residential postcodes. The median age of Indigenous patients (45 years; IQR, 34-57 years) was lower than for non-Indigenous ICU patients (64 years; IQR, 47-76 years). For patients with South Australian postcodes, unadjusted mortality at discharge and 12 months and 8 years after admission was lower for Indigenous patients; after adjusting for age, sex, diabetes, severity of illness, and diagnostic group, mortality was similar for both groups at discharge (adjusted odds ratio [aOR], 0.95; 95% CI, 0.81-1.10), but greater for Indigenous patients at 12 months (aOR, 1.14; 95% CI, 1.03-1.26) and 8 years (adjusted hazard ratio, 1.23; 95% CI, 1.13-1.35). The number of potential years of life lost was greater for Indigenous patients (median, 24.0; IQR, 15.8-31.8 v 12.5; IQR, 0-22.3), but, referenced to respective population life expectancies, relative survival at 8 years was similar (proportions: Indigenous, 0.78; 95% CI, 0.75-0.80; non-Indigenous, 0.77; 95% CI, 0.76-0.78).CONCLUSIONS: Adjusted long term mortality and median number of potential life years lost are higher for Indigenous than non-Indigenous patients after intensive care in hospital. These differences reflect underlying population survival patterns rather than the effects of ICU admission.",

keywords = "Aboriginal and Torres Strait islander Australians, intensive care units, Long term, outcomes",

author = "Mitchell, {William G} and Adam Deane and Alex Brown and Shailesh Bihari and Hao Wong and Rajaram Ramadoss and Mark Finnis",

note = "{\textcopyright} 2020 AMPCo Pty Ltd.",

year = "2020",

month = jun,

day = "2",

doi = "10.5694/mja2.50649",

language = "English",

volume = "213",

pages = "16--21",

journal = "The Medical journal of Australia",

issn = "0025-729X",

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TY - JOUR

T1 - Long term outcomes for Aboriginal and Torres Strait Islander Australians after hospital intensive care

AU - Mitchell, William G

AU - Deane, Adam

AU - Brown, Alex

AU - Bihari, Shailesh

AU - Wong, Hao

AU - Ramadoss, Rajaram

AU - Finnis, Mark

PY - 2020/6/2

Y1 - 2020/6/2

N2 - OBJECTIVES: To assess long term outcomes for Aboriginal and Torres Strait Islander (Indigenous) Australians admitted non-electively to intensive care units (ICUs).DESIGN: Data linkage cohort study; analysis of ICU patient data (Australian and New Zealand Intensive Care Society Adult Patient Database), prospectively collected during 2007-2016.SETTING: All four university-affiliated level 3 ICUs in South Australia.MAIN OUTCOMES: Mortality (in-hospital, and 12 months and 8 years after admission to ICU), by Indigenous status.RESULTS: 2035 of 39 784 non-elective index ICU admissions (5.1%) were of Indigenous Australians, including 1461 of 37 661 patients with South Australian residential postcodes. The median age of Indigenous patients (45 years; IQR, 34-57 years) was lower than for non-Indigenous ICU patients (64 years; IQR, 47-76 years). For patients with South Australian postcodes, unadjusted mortality at discharge and 12 months and 8 years after admission was lower for Indigenous patients; after adjusting for age, sex, diabetes, severity of illness, and diagnostic group, mortality was similar for both groups at discharge (adjusted odds ratio [aOR], 0.95; 95% CI, 0.81-1.10), but greater for Indigenous patients at 12 months (aOR, 1.14; 95% CI, 1.03-1.26) and 8 years (adjusted hazard ratio, 1.23; 95% CI, 1.13-1.35). The number of potential years of life lost was greater for Indigenous patients (median, 24.0; IQR, 15.8-31.8 v 12.5; IQR, 0-22.3), but, referenced to respective population life expectancies, relative survival at 8 years was similar (proportions: Indigenous, 0.78; 95% CI, 0.75-0.80; non-Indigenous, 0.77; 95% CI, 0.76-0.78).CONCLUSIONS: Adjusted long term mortality and median number of potential life years lost are higher for Indigenous than non-Indigenous patients after intensive care in hospital. These differences reflect underlying population survival patterns rather than the effects of ICU admission.

AB - OBJECTIVES: To assess long term outcomes for Aboriginal and Torres Strait Islander (Indigenous) Australians admitted non-electively to intensive care units (ICUs).DESIGN: Data linkage cohort study; analysis of ICU patient data (Australian and New Zealand Intensive Care Society Adult Patient Database), prospectively collected during 2007-2016.SETTING: All four university-affiliated level 3 ICUs in South Australia.MAIN OUTCOMES: Mortality (in-hospital, and 12 months and 8 years after admission to ICU), by Indigenous status.RESULTS: 2035 of 39 784 non-elective index ICU admissions (5.1%) were of Indigenous Australians, including 1461 of 37 661 patients with South Australian residential postcodes. The median age of Indigenous patients (45 years; IQR, 34-57 years) was lower than for non-Indigenous ICU patients (64 years; IQR, 47-76 years). For patients with South Australian postcodes, unadjusted mortality at discharge and 12 months and 8 years after admission was lower for Indigenous patients; after adjusting for age, sex, diabetes, severity of illness, and diagnostic group, mortality was similar for both groups at discharge (adjusted odds ratio [aOR], 0.95; 95% CI, 0.81-1.10), but greater for Indigenous patients at 12 months (aOR, 1.14; 95% CI, 1.03-1.26) and 8 years (adjusted hazard ratio, 1.23; 95% CI, 1.13-1.35). The number of potential years of life lost was greater for Indigenous patients (median, 24.0; IQR, 15.8-31.8 v 12.5; IQR, 0-22.3), but, referenced to respective population life expectancies, relative survival at 8 years was similar (proportions: Indigenous, 0.78; 95% CI, 0.75-0.80; non-Indigenous, 0.77; 95% CI, 0.76-0.78).CONCLUSIONS: Adjusted long term mortality and median number of potential life years lost are higher for Indigenous than non-Indigenous patients after intensive care in hospital. These differences reflect underlying population survival patterns rather than the effects of ICU admission.

KW - Aboriginal and Torres Strait islander Australians

KW - intensive care units

KW - Long term

KW - outcomes

U2 - 10.5694/mja2.50649

DO - 10.5694/mja2.50649

M3 - Article

C2 - 32484925

SN - 0025-729X

VL - 213

SP - 16

EP - 21

JO - The Medical journal of Australia

JF - The Medical journal of Australia

IS - 1

ER -