Trauma-related admissions to intensive care units in Australia: the influence of Indigenous status on outcomes.

Abstract

To investigate the admission characteristics and hospital outcomes for Indigenous and non-Indigenous patients admitted to intensive units (ICUs) after major trauma. 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. Patients older than 17 years of age admitted to public hospital ICUs with a primary diagnosis of trauma. ICU and overall hospital lengths of stay, hospital discharge destination, and ICU and overall hospital mortality rates for Indigenous and non-Indigenous patients. 23 804 people were admitted to Australian public hospital ICUs after major trauma; 3058 (12.8%) were Indigenous Australians. The population-standardised incidence of admissions was consistently higher for Indigenous Australians than for non-Indigenous Australians (1505 per million v 245 per million population; incidence ratio, 6.1; 95% CI, 5.9-6.4). Overall hospital mortality rates were similar for Indigenous and non-Indigenous patients (adjusted odds ratio [aOR], 1.01; 95% CI, 0.85-1.20). Indigenous patients were significantly more likely than non-Indigenous patients to be discharged to a rehabilitation facility (aOR, 1.98; 95% CI, 1.80-2.17) and less likely to be discharged home (aOR, 0.73; 95% CI, 0.65-0.82). 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 rehabilitation facility and less likely to be discharged home than non-Indigenous patients.