Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/22696
Title: Characteristics and Outcomes of Critically Ill Trauma Patients in Australia and New Zealand (2005-2017).
Authors: Wilson, Anthony J;Magee, Fraser;Bailey, Michael;Pilcher, David V;French, Craig;Nichol, Alistair;Udy, Andrew;Hodgson, Carol L;Cooper, D James;Reade, Michael C;Young, Paul;Bellomo, Rinaldo
Affiliation: Joint Health Command, Australian Defense Force, Canberra, ACT, Australia
The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation (CORE), Camberwell, VIC, Australia
Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Adult Critical Care, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
Department of Intensive Care, Western Health, Melbourne, VIC, Australia
Medical Research Institute of New Zealand, Wellington, New Zealand
Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
Australian and New Zealand Intensive Care Research Centre (ANZIC RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
School of Medicine, The University of Melbourne, Melbourne, VIC, Australia
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
Clinical Research Centre, School of Medicine, University College Dublin, Dublin, Ireland
Department of Intensive Care and Hyperbaric Medicine, The Alfred, Commercial Road, Melbourne, VIC, Australia
Department of Medicine and Radiology, University of Melbourne, Melbourne, VIC, Australia
0000-0002-1650-8939
Issue Date: 27-Feb-2020
EDate: 2020-02-27
Citation: Critical care medicine 2020; online first: 27 February
Abstract: To compare the characteristics of adults admitted to the ICU in Australia and New Zealand after trauma with nonelective, nontrauma admissions. To describe trends in hospital mortality and rates of discharge home among these two groups. Retrospective review (2005-2017) of the Australia and New Zealand Intensive Care Society's Center for Outcome and Resource Evaluation Adult Patient Database. Adult ICUs in Australia and New Zealand. Adult (≥17 yr), nonelective, ICU admissions. Observational study. We compared 77,002 trauma with 741,829 nonelective, nontrauma patients. Trauma patients were younger (49.0 ± 21.6 vs 60.6 ± 18.7 yr; p < 0.0001), predominantly male (73.1% vs 53.9%; p < 0.0001), and more frequently treated in tertiary hospitals (74.7% vs 45.8%; p < 0.0001). The mean age of trauma patients increased over time but was virtually static for nonelective, nontrauma patients (0.72 ± 0.02 yr/yr vs 0.03 ± 0.01 yr/yr; p < 0.0001). Illness severity increased for trauma but fell for nonelective, nontrauma patients (mean Australia and New Zealand risk of death: 0.10% ± 0.02%/yr vs -0.21% ± 0.01%/yr; p < 0.0001). Trauma patients had a lower hospital mortality than nonelective, nontrauma patients (10.0% vs 15.8%; p < 0.0001). Both groups showed an annual decline in the illness severity adjusted odds ratio (odds ratio) of hospital mortality, but this was slower among trauma patients (trauma: odds ratio 0.976/yr [0.968-0.984/yr; p < 0.0001]; nonelective, nontrauma: odds ratio 0.957/yr [0.955-0.959/yr; p < 0.0001]; interaction p < 0.0001). Trauma patients had lower rates of discharge home than nonelective, nontrauma patients (56.7% vs 64.6%; p < 0.0001). There was an annual decline in illness severity adjusted odds ratio of discharge home among trauma patients, whereas nonelective, nontrauma patients displayed an annual increase (trauma: odds ratio 0.986/yr [0.981-0.990/yr; p < 0.0001]; nonelective, nontrauma: odds ratio 1.014/yr [1.012-1.016/yr; p < 0.0001]; interaction: p < 0.0001). The age and illness severity of adult ICU trauma patients in Australia and New Zealand has increased over time. Hospital mortality is lower for trauma than other nonelective ICU patients but has fallen more slowly. Trauma patients have become less likely to be discharged home than other nonelective ICU patients.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22696
DOI: 10.1097/CCM.0000000000004284
PubMed URL: 32108705
Type: Journal Article
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.