• Paul Secombe, Alex Brown, Greg McAnulty, and David Pilcher.
• Intensive Care Unit, Alice Springs Hospital, Alice Springs, NT, Australia. Paul.Secombe@nt.gov.au.
• Crit Care Resusc. 2019 Sep 1; 21 (3): 200-211.

ObjectiveTo provide a contemporary description of the demographics, characteristics and outcomes of critically ill Indigenous patients in Australia.Design, Setting And ParticipantsRetrospective database review using the Australian and New Zealand Intensive Care Society Adult Patient Database for intensive care unit (ICU) admissions in 2017-18. Characteristics of critically ill Indigenous patients were compared with non-Indigenous patients.Main Outcome MeasuresPrimary outcome was hospital mortality. Secondary outcomes examined demographics and resource use.ResultsPer capita, Indigenous Australians were overrepresented in the intensive care. They were younger (51 v 66 years), more likely to be admitted from outer regional, rural and remote settings (59% v 15%), more likely to require emergency admission (81% v 59%), and had higher rates of mechanical ventilation (35% v 32%; P < 0.01 for all). Indigenous patients were over-represented in the diagnostic categories of sepsis (15% v 9%), trauma (7% v 5%), and respiratory illness (17% v 15%), and had higher rates of ICU re-admission (7% v 5%; P < 0.01 for all). There was no difference in either unadjusted (7.9% for each; P = 0.96) or adjusted (odds ratio, 1.1; 95% CI, 1.0-1.2) in-hospital mortality.ConclusionIndigenous patients, especially young Indigenous patients, were disproportionately represented in Australian ICUs, particularly for sepsis. The high level of acute illness and high proportion of emergency admissions could be interpreted as representing delayed presentation, which, with a higher re-admission rate, suggest access barriers to health care may exist. Nevertheless, there was no mortality gap between Indigenous and non-Indigenous Australians during a hospital admission for critical illness.

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