Paul J. Young BSc (Hons), MBChB, PhD , Michael Bailey PhD , the ANZICS CORE Management Committee
{"title":"2009年至2018年新西兰重症监护病房收治的太平洋和欧洲裔患者的治疗结果","authors":"Paul J. Young BSc (Hons), MBChB, PhD , Michael Bailey PhD , the ANZICS CORE Management Committee","doi":"10.1016/j.ccrj.2024.04.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To describe the characteristics and outcomes of Pacific and European patients admitted to New Zealand (NZ) intensive care units (ICUs) 2009–2018.</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Setting and participants</h3><p>The NZ Ministry of Health National Minimum Dataset and the Australia NZ Intensive Care Society Adult Patient Database were matched. Data were for ICU admissions in NZ hospitals from July 2009 until June 2018; long-term mortality outcomes were obtained from the NZ death registry until June 2020.</p></div><div><h3>Main outcome measures</h3><p>The primary outcome was day 180 mortality. Secondary outcomes were ICU mortality, hospital mortality, discharge to home, ICU and hospital length of stay, and survival. We evaluated the associations between Pacific ethnicity and outcomes with European as the reference using regression analyses. We adjusted sequentially for site, deprivation status, sex, year of admission, Charlson Comorbidity Index, age, admission source and type, ICU admission diagnosis, ventilation status, and illness severity.</p></div><div><h3>Results</h3><p>Pacific people had a median age of 14 years younger than Europeans. 644/4603 (14.0%) Pacific, and 6407/42,871 (14.9%) European patients died within 180 days of ICU admission; odds ratio (OR) 0.93; 95% CI, 0.85–1.01. When adjusting for age, the OR for day 180 mortality for Pacific vs. European patients increased. The OR decreased after adjustment for admission source and type, and after accounting for Pacific patients having a higher comorbidity index and more severe illness. In the final model, incorporating adjustments for all specified variables, Pacific ethnicity was not significantly associated with day 180 mortality (adjusted OR 0.91; 95% CI, 0.80–1.05). Findings were similar for secondary outcomes except for the proportion of patients discharged home; Pacific ethnicity was associated with significantly increased odds of being discharged home compared to European ethnicity.</p></div><div><h3>Conclusions</h3><p>Pacific ethnicity was not associated with increased day 180 mortality compared to European ethnicity; Pacific patients admitted to the ICU were more likely to be discharged home than European patients.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277224000115/pdfft?md5=880b7a9f126f0c2ff2413131fdc633b9&pid=1-s2.0-S1441277224000115-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Outcomes for Pacific and European patients admitted to New Zealand intensive care units from 2009 to 2018\",\"authors\":\"Paul J. Young BSc (Hons), MBChB, PhD , Michael Bailey PhD , the ANZICS CORE Management Committee\",\"doi\":\"10.1016/j.ccrj.2024.04.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To describe the characteristics and outcomes of Pacific and European patients admitted to New Zealand (NZ) intensive care units (ICUs) 2009–2018.</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Setting and participants</h3><p>The NZ Ministry of Health National Minimum Dataset and the Australia NZ Intensive Care Society Adult Patient Database were matched. Data were for ICU admissions in NZ hospitals from July 2009 until June 2018; long-term mortality outcomes were obtained from the NZ death registry until June 2020.</p></div><div><h3>Main outcome measures</h3><p>The primary outcome was day 180 mortality. Secondary outcomes were ICU mortality, hospital mortality, discharge to home, ICU and hospital length of stay, and survival. We evaluated the associations between Pacific ethnicity and outcomes with European as the reference using regression analyses. We adjusted sequentially for site, deprivation status, sex, year of admission, Charlson Comorbidity Index, age, admission source and type, ICU admission diagnosis, ventilation status, and illness severity.</p></div><div><h3>Results</h3><p>Pacific people had a median age of 14 years younger than Europeans. 644/4603 (14.0%) Pacific, and 6407/42,871 (14.9%) European patients died within 180 days of ICU admission; odds ratio (OR) 0.93; 95% CI, 0.85–1.01. When adjusting for age, the OR for day 180 mortality for Pacific vs. European patients increased. The OR decreased after adjustment for admission source and type, and after accounting for Pacific patients having a higher comorbidity index and more severe illness. In the final model, incorporating adjustments for all specified variables, Pacific ethnicity was not significantly associated with day 180 mortality (adjusted OR 0.91; 95% CI, 0.80–1.05). Findings were similar for secondary outcomes except for the proportion of patients discharged home; Pacific ethnicity was associated with significantly increased odds of being discharged home compared to European ethnicity.</p></div><div><h3>Conclusions</h3><p>Pacific ethnicity was not associated with increased day 180 mortality compared to European ethnicity; Pacific patients admitted to the ICU were more likely to be discharged home than European patients.</p></div>\",\"PeriodicalId\":49215,\"journal\":{\"name\":\"Critical Care and Resuscitation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1441277224000115/pdfft?md5=880b7a9f126f0c2ff2413131fdc633b9&pid=1-s2.0-S1441277224000115-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Critical Care and Resuscitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1441277224000115\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care and Resuscitation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1441277224000115","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的描述2009-2018年入住新西兰(NZ)重症监护病房(ICU)的太平洋地区和欧洲地区患者的特征和预后.设计回顾性队列研究.设置和参与者新西兰卫生部国家最低数据集与澳大利亚新西兰重症监护协会成人患者数据库进行了匹配。数据来自2009年7月至2018年6月期间新西兰医院的重症监护病房入院情况;长期死亡率结果来自2020年6月之前的新西兰死亡登记。次要结果为重症监护室死亡率、住院死亡率、出院回家率、重症监护室和住院时间以及存活率。我们使用回归分析评估了太平洋岛屿族裔与以欧洲裔为参照的结果之间的关系。我们依次对地点、贫困状况、性别、入院年份、夏尔森综合症指数、年龄、入院来源和类型、ICU入院诊断、通气状况和疾病严重程度进行了调整。644/4603(14.0%)名太平洋裔患者和 6407/42,871 (14.9%)名欧洲裔患者在入住 ICU 后 180 天内死亡;几率比 (OR) 为 0.93;95% CI 为 0.85-1.01。在对年龄进行调整后,太平洋裔患者与欧裔患者的 180 天死亡率比值增加。在对入院来源和类型进行调整,并考虑到太平洋裔患者的合并症指数更高、病情更严重的因素后,OR 有所下降。在对所有特定变量进行调整后的最终模型中,太平洋岛屿族裔与第 180 天死亡率无显著相关性(调整后 OR 为 0.91;95% CI 为 0.80-1.05)。除了出院回家的患者比例外,其他次要结果的研究结果相似;与欧洲裔患者相比,太平洋岛屿族裔患者出院回家的几率明显增加。结论与欧洲裔患者相比,太平洋岛屿族裔患者与第180天死亡率增加无关;与欧洲裔患者相比,入住重症监护室的太平洋岛屿族裔患者更有可能出院回家。
Outcomes for Pacific and European patients admitted to New Zealand intensive care units from 2009 to 2018
Objective
To describe the characteristics and outcomes of Pacific and European patients admitted to New Zealand (NZ) intensive care units (ICUs) 2009–2018.
Design
Retrospective cohort study.
Setting and participants
The NZ Ministry of Health National Minimum Dataset and the Australia NZ Intensive Care Society Adult Patient Database were matched. Data were for ICU admissions in NZ hospitals from July 2009 until June 2018; long-term mortality outcomes were obtained from the NZ death registry until June 2020.
Main outcome measures
The primary outcome was day 180 mortality. Secondary outcomes were ICU mortality, hospital mortality, discharge to home, ICU and hospital length of stay, and survival. We evaluated the associations between Pacific ethnicity and outcomes with European as the reference using regression analyses. We adjusted sequentially for site, deprivation status, sex, year of admission, Charlson Comorbidity Index, age, admission source and type, ICU admission diagnosis, ventilation status, and illness severity.
Results
Pacific people had a median age of 14 years younger than Europeans. 644/4603 (14.0%) Pacific, and 6407/42,871 (14.9%) European patients died within 180 days of ICU admission; odds ratio (OR) 0.93; 95% CI, 0.85–1.01. When adjusting for age, the OR for day 180 mortality for Pacific vs. European patients increased. The OR decreased after adjustment for admission source and type, and after accounting for Pacific patients having a higher comorbidity index and more severe illness. In the final model, incorporating adjustments for all specified variables, Pacific ethnicity was not significantly associated with day 180 mortality (adjusted OR 0.91; 95% CI, 0.80–1.05). Findings were similar for secondary outcomes except for the proportion of patients discharged home; Pacific ethnicity was associated with significantly increased odds of being discharged home compared to European ethnicity.
Conclusions
Pacific ethnicity was not associated with increased day 180 mortality compared to European ethnicity; Pacific patients admitted to the ICU were more likely to be discharged home than European patients.
期刊介绍:
ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines.
The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world.
The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.