Although a study of intensive care unit (ICU) admissions for community-acquired sepsis found no evidence of associations between in-hospital mortality and ethnicity or socioeconomic deprivation, there were marked disparities post-discharge. Data for the study were retrieved from the Australian and New Zealand Intensive Care Society’s CORE adult patient database for the period 2009 to 2019. The in-hospital mortality rate was 16.3%, and post-discharge mortality rates were 3.6% at 30 days, 9.1% at 180 days and 12.9% at 365 days. Post-discharge survival rates were significantly different when analysed by ethnicity, area deprivation quintile and presence of severe comorbidities; this was particularly apparent for Māori living in high-deprivation areas.
The finding that in-hospital mortality did not differ by ethnicity or socioeconomic status is encouraging and suggests satisfactory quality of care within the ICU environment. However, it also raises critical questions about the continuum of care for people leaving ICU, or in fact hospital in general, and the importance of discharge planning on health (and death) outcomes.
Independent commentary by Dr. Matire Hardwood
Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.
Research Review publications are intended for New Zealand health professionals.
Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.
