Incidence and outcomes of critical illness in indigenous peoples: a systematic review and meta-analysis

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dc.contributor.authorBowker, Samantha L.
dc.contributor.authorWilliams, Kienan
dc.contributor.authorVolk, Auriele
dc.contributor.authorAuger, Leonard
dc.contributor.authorLafontaine, Alika
dc.contributor.authorDumont, Paige
dc.contributor.authorWingert, Aireen
dc.contributor.authorDavis, Amanda
dc.contributor.authorBialy, Liza
dc.contributor.authorWright, Erica
dc.contributor.authorOster, Richard T.
dc.contributor.authorBagshaw, Sean M.
dc.date.accessioned2023-07-16T00:03:10Z
dc.date.available2023-07-16T00:03:10Z
dc.date.issued2023-07-13
dc.date.updated2023-07-16T00:03:09Z
dc.description.abstractAbstract Background Indigenous Peoples experience health inequities and racism across the continuum of health services. We performed a systematic review and meta-analysis of the incidence and outcomes of critical illness among Indigenous Peoples. Methods We searched Ovid MEDLINE/PubMed, Ovid EMBASE, Google Scholar, and Cochrane Central Register of Controlled Trials (inception to October 2022). Observational studies, case series of > 100 patients, clinical trial arms, and grey literature reports of Indigenous adults were eligible. We assessed risk of bias using the Newcastle–Ottawa Scale and appraised research quality from an Indigenous perspective using the Aboriginal and Torres Strait Islander Quality Assessment Tool. ICU mortality, ICU length of stay, and invasive mechanical ventilation (IMV) were compared using risk ratios and mean difference (MD) for dichotomous and continuous outcomes, respectively. ICU admission was synthesized descriptively. Results Fifteen studies (Australia and/or New Zealand [n = 12] and Canada [n = 3]) were included. Risk of bias was low in 10 studies and moderate in 5, and included studies had minimal incorporation of Indigenous perspectives or consultation. There was no difference in ICU mortality between Indigenous and non-Indigenous (RR 1.14, 95%CI 0.98 to 1.34, I2 = 87%). We observed a shorter ICU length of stay among Indigenous (MD − 0.25; 95%CI, − 0.49 to − 0.00; I2 = 95%) and a higher use for IMV among non-Indigenous (RR 1.10; 95%CI, 1.06 to 1.15; I2 = 81%). Conclusion Research on Indigenous Peoples experience with critical care is poorly characterized and has rarely included Indigenous perspectives. ICU mortality between Indigenous and non-Indigenous populations was similar, while there was a shorter ICU length of stay and less mechanical ventilation use among Indigenous patients. Systematic Review Registration PROSPERO CRD42021254661; Registered: 12 June, 2021.
dc.identifier.citationCritical Care. 2023 Jul 13;27(1):285
dc.identifier.urihttps://doi.org/10.1186/s13054-023-04570-y
dc.identifier.urihttps://hdl.handle.net/1880/116732
dc.identifier.urihttps://dx.doi.org/10.11575/PRISM/41574
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleIncidence and outcomes of critical illness in indigenous peoples: a systematic review and meta-analysis
dc.typeJournal Article
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