The outcome of critically ill Indigenous patients.
OBJECTIVE
To investigate the short-term outcome of critically ill Indigenous patients.


METHODS
Retrospective cohort study using de-identified audit data from a tertiary intensive care unit (ICU) in Western Australia for the 11-year period 1 January 1993 to 31 December 2003.


METHODS
Hospital mortality (crude, and adjusted for severity of illness).


RESULTS
Of 16 757 ICU patients, 1076 (6.4%) were identified as Indigenous. The Indigenous patients were younger and more commonly had chronic liver and renal diseases. Indigenous people represented 3.2% of the population of Western Australia in 2001, but represented 3.1% and 9.5% of all elective and emergency ICU admissions, respectively. Diagnoses of sepsis, pneumonia, trauma, and cardiopulmonary arrest were common among critically ill Indigenous patients. Following emergency admission, the crude hospital mortality for Indigenous patients was higher (22.7% v 19.2%; crude odds ratio, 1.24; 95% CI, 1.04-1.47) than for non-Indigenous patients. The crude hospital mortality of critically ill Indigenous patients was lower than that predicted by the APACHE II prognostic model and was similar to that of non-Indigenous patients after adjusting for severity of illness and chronic health status.


CONCLUSIONS
The pattern of critical illness affecting Indigenous Australians in Western Australia was different from that affecting non-Indigenous patients. The crude hospital mortality was high, but similar to that of non-Indigenous Australians after adjusting for severity of illness and chronic health status.
Ho
Kwok Ming
KM
Intensive Care, Royal Perth Hospital, Perth, WA, Australia. kwok.ho@health.wa.gov.au
Finn
Judith
J
Dobb
Geoffrey J
GJ
Webb
Steven A R
SA
D018806:APACHE; D000328:Adult; D016638:Critical Illness / Q000145:classification / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014904:Western Australia / Q000453:epidemiology