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 journalArticlepeer-review

3 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 languageEnglish
Pages (from-to)16-21
Number of pages6
JournalThe Medical journal of Australia
Volume213
Issue number1
DOIs
Publication statusPublished or Issued - 2 Jun 2020
Externally publishedYes

Keywords

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

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