Indigenous Outcomes in Major Burns (≥20% TBSA) – Are We Failing to Provide an Equitable Health Service?
Jenyu Shaw1, Michael Muller 1Royal Brisbane And Women’s Hosptial, Herston , Queensland, Australia
Abstract
Background: Australian Aboriginal and Torres Strait Islander (ATSI) people are predisposed to poor health outcomes in all facets of healthcare (Schultz & Cairney 2017). No study has been designed to compare these outcomes to non-indigenous patients in major burns.
Purpose: Compare the outcomes of major burns between the Australian indigenous and non-indigenous population at the Royal Brisbane and Women’s Hospital (RBWH).
Method: Ethics exemption was obtained for an eight-year retrospective study from 2014 to 2022. Patient data was accessed via integrated electronic medical records (ieMR). Inclusion criteria comprised of age ≥16 at time of injury, and burn ≥20% TBSA.
Results: A total of 266 patients met inclusion criteria. The ATSI population comprised 29 (10.9%) of the dataset (23 [79.3%] males and 6 [20.7%] females). The average TBSA was 35.88±13.60%, compared to 40.24±21.61% in the non-indigenous population. There was no significant difference in time to initial debridement (39.32h, 47.55h, p-value = 0.10), however an increased rate of ICU admission (86.2%, 72.2%, p-value <0.05) and acute hospital length of stay (LoS) (32.10d, 27.73d, p-value <0.05) was observed. There was a significant increase in intubation rates (72.4%, 65.4%, p-value <0.05), but overall mortality was observed to be decreased (6.9%, 19.5%, p-value <0.05). Conclusion: This data suggests that there is no significant difference in multiple outcome categories including time to initial debridement and mortality. However, the indigenous people continue to be subject to increased rates of intubation, ICU admission, and acute hospital LoS. This research provides statistical evidence as foundation to further study ascertaining barriers to improved outcomes. Schultz, R. and Cairney, S., 2017. Caring for country and the health of Aboriginal and Torres Strait Islander Australians. Med J Aust, 207(1), pp.8-10.
Biography
I am a surgical Senior House Officer currently placed at the Royal Brisbane and Women’s Hospital. I am particularly interested in general surgery, including trauma and burns.