Young Paul J, Bailey Michael
Intensive Care Unit, Wellington Hospital, Wellington, New Zealand.
Medical Research Institute of New Zealand, Wellington, New Zealand.
Crit Care Resusc. 2024 Jun 20;26(2):100-107. doi: 10.1016/j.ccrj.2024.04.002. eCollection 2024 Jun.
To describe the characteristics and outcomes of Pacific and European patients admitted to New Zealand (NZ) intensive care units (ICUs) 2009-2018.
Retrospective cohort study.
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.
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.
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.
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.
描述2009年至2018年入住新西兰重症监护病房（ICU）的太平洋岛民和欧洲患者的特征及预后。
回顾性队列研究。
将新西兰卫生部国家最低数据集与澳大利亚和新西兰重症监护学会成人患者数据库进行匹配。数据来自2009年7月至2018年6月期间新西兰医院的ICU入院患者；长期死亡率数据来自新西兰死亡登记处，截至2020年6月。
主要结局为第180天死亡率。次要结局包括ICU死亡率、医院死亡率、出院回家情况、ICU和医院住院时间以及生存率。我们以欧洲人为参照，通过回归分析评估太平洋岛民种族与结局之间的关联。我们依次对地点、贫困状况、性别、入院年份、查尔森合并症指数、年龄、入院来源和类型、ICU入院诊断、通气状态以及疾病严重程度进行了调整。
太平洋岛民的年龄中位数比欧洲人小14岁。644/4603（14.0%）的太平洋岛民患者和6407/42871（14.9%）的欧洲患者在ICU入院180天内死亡；比值比（OR）为0.9；95%置信区间（CI）为0.85 - 1.01。在对年龄进行调整后，太平洋岛民患者与欧洲患者相比，第180天死亡率的OR值增加。在对入院来源和类型进行调整后，以及在考虑到太平洋岛民患者合并症指数更高且疾病更严重之后，OR值下降。在纳入对所有指定变量的调整的最终模型中，太平洋岛民种族与第180天死亡率无显著关联（调整后OR为0.91；95%CI为0.80 - 1.05）。除出院回家患者比例外，次要结局的结果相似；与欧洲种族相比，太平洋岛民种族出院回家的几率显著增加。
与欧洲种族相比，太平洋岛民种族与第180天死亡率增加无关；入住ICU的太平洋岛民患者比欧洲患者更有可能出院回家。
