Postoperative outcomes for Nunavut Inuit at a Canadian quaternary care centre: a retrospective cohort study.
BACKGROUND: Structural aspects of health care systems, such as limited access to specialized surgical and perioperative care, can negatively affect the outcomes and resource use of patients undergoing elective and emergency surgical procedures. The aim of this study was to compare postoperative outc...
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Canada
2022
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ftnorthernterhls:oai:digitallibrary.health.nt.gov.au:10137/12173 2023-05-15T16:54:06+02:00 Postoperative outcomes for Nunavut Inuit at a Canadian quaternary care centre: a retrospective cohort study. McVicar, Jason A Hoang-Nguyen, Jenny O'Shea, Justine Champion, Caitlin Sheffield, Chelsey Allen, Jean Kimmaliardjuk, Donna May Poon, Alana Bould, M Dylan Nickerson, Jason W Caron, Nadine R McIsaac, Daniel I 2022-05-03 E304-E312 https://hdl.handle.net/10137/12173 https://doi.org/10.9778/cmajo.20210108 https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/35504694 eng eng Canada © 2022 CMA Impact Inc. or its licensors. CMAJ Open. 2022 May 3;10(2):E304-E312. doi:10.9778/cmajo.20210108. Print 2022 Apr-Jun. 101620603 https://hdl.handle.net/10137/12173 CMAJ open doi:10.9778/cmajo.20210108 https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/35504694 10 Adult Canada Hospital Mortality Humans *Inuits Nunavut/epidemiology Retrospective Studies Journal Article 2022 ftnorthernterhls https://doi.org/10.9778/cmajo.20210108 2023-03-06T23:15:58Z BACKGROUND: Structural aspects of health care systems, such as limited access to specialized surgical and perioperative care, can negatively affect the outcomes and resource use of patients undergoing elective and emergency surgical procedures. The aim of this study was to compare postoperative outcomes of Nunavut Inuit and non-Inuit patients at a Canadian quaternary care centre. METHODS: We conducted a retrospective cohort study involving adult (age ≥ 18 yr) patients undergoing inpatient surgery from 2011 to 2018 at The Ottawa Hospital, the quaternary referral hospital for the Qikiqtaaluk Region of Nunavut. The study was designed and conducted in collaboration with Nunavut Tunngavik Incorporated. The primary outcome was a composite of in-hospital death or complications.Secondary outcomes included postoperative length of stay in hospital, adverse discharge disposition, readmissions within 30 days and total hospitalization costs. RESULTS: A total of 98 701 episodes of inpatient surgical care occurred among patients aged 18 to 104 years; 928 (0.9%) of these involved Nunavut Inuit, and 97 773 involved non-Inuit patients. Death or postoperative complication occurred more often among Nunavut Inuit than non-Inuit patients (159 [17.2%] v. 15 691 [16.1%]), which was significantly different after adjustment for age, sex, surgical specialty, risk and urgency (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.03-1.51). This association was most pronounced in cases of cancer (OR 1.63, 95% CI 1.03-2.58) and elective surgery (OR 1.58, 95% CI 1.20-2.10). Adjusted rates of readmission, adverse discharge disposition, length of stay and total costs were significantly higher for Nunavut Inuit. INTERPRETATION: Nunavut Inuit had a 25% relative increase in their odds of morbidity and death after surgery at a major quaternary care hospital in Canada compared with non-Inuit patients, while also having higher rates of other adverse outcomes and resource use. An examination of perioperative systems involving patients, Inuit ... Article in Journal/Newspaper inuit inuits Nunavut Qikiqtaaluk Northern Territory Government Health Library Services ePublications Canada Nunavut CMAJ Open 10 2 E304 E312 |
institution |
Open Polar |
collection |
Northern Territory Government Health Library Services ePublications |
op_collection_id |
ftnorthernterhls |
language |
English |
topic |
Adult Canada Hospital Mortality Humans *Inuits Nunavut/epidemiology Retrospective Studies |
spellingShingle |
Adult Canada Hospital Mortality Humans *Inuits Nunavut/epidemiology Retrospective Studies McVicar, Jason A Hoang-Nguyen, Jenny O'Shea, Justine Champion, Caitlin Sheffield, Chelsey Allen, Jean Kimmaliardjuk, Donna May Poon, Alana Bould, M Dylan Nickerson, Jason W Caron, Nadine R McIsaac, Daniel I Postoperative outcomes for Nunavut Inuit at a Canadian quaternary care centre: a retrospective cohort study. |
topic_facet |
Adult Canada Hospital Mortality Humans *Inuits Nunavut/epidemiology Retrospective Studies |
description |
BACKGROUND: Structural aspects of health care systems, such as limited access to specialized surgical and perioperative care, can negatively affect the outcomes and resource use of patients undergoing elective and emergency surgical procedures. The aim of this study was to compare postoperative outcomes of Nunavut Inuit and non-Inuit patients at a Canadian quaternary care centre. METHODS: We conducted a retrospective cohort study involving adult (age ≥ 18 yr) patients undergoing inpatient surgery from 2011 to 2018 at The Ottawa Hospital, the quaternary referral hospital for the Qikiqtaaluk Region of Nunavut. The study was designed and conducted in collaboration with Nunavut Tunngavik Incorporated. The primary outcome was a composite of in-hospital death or complications.Secondary outcomes included postoperative length of stay in hospital, adverse discharge disposition, readmissions within 30 days and total hospitalization costs. RESULTS: A total of 98 701 episodes of inpatient surgical care occurred among patients aged 18 to 104 years; 928 (0.9%) of these involved Nunavut Inuit, and 97 773 involved non-Inuit patients. Death or postoperative complication occurred more often among Nunavut Inuit than non-Inuit patients (159 [17.2%] v. 15 691 [16.1%]), which was significantly different after adjustment for age, sex, surgical specialty, risk and urgency (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.03-1.51). This association was most pronounced in cases of cancer (OR 1.63, 95% CI 1.03-2.58) and elective surgery (OR 1.58, 95% CI 1.20-2.10). Adjusted rates of readmission, adverse discharge disposition, length of stay and total costs were significantly higher for Nunavut Inuit. INTERPRETATION: Nunavut Inuit had a 25% relative increase in their odds of morbidity and death after surgery at a major quaternary care hospital in Canada compared with non-Inuit patients, while also having higher rates of other adverse outcomes and resource use. An examination of perioperative systems involving patients, Inuit ... |
format |
Article in Journal/Newspaper |
author |
McVicar, Jason A Hoang-Nguyen, Jenny O'Shea, Justine Champion, Caitlin Sheffield, Chelsey Allen, Jean Kimmaliardjuk, Donna May Poon, Alana Bould, M Dylan Nickerson, Jason W Caron, Nadine R McIsaac, Daniel I |
author_facet |
McVicar, Jason A Hoang-Nguyen, Jenny O'Shea, Justine Champion, Caitlin Sheffield, Chelsey Allen, Jean Kimmaliardjuk, Donna May Poon, Alana Bould, M Dylan Nickerson, Jason W Caron, Nadine R McIsaac, Daniel I |
author_sort |
McVicar, Jason A |
title |
Postoperative outcomes for Nunavut Inuit at a Canadian quaternary care centre: a retrospective cohort study. |
title_short |
Postoperative outcomes for Nunavut Inuit at a Canadian quaternary care centre: a retrospective cohort study. |
title_full |
Postoperative outcomes for Nunavut Inuit at a Canadian quaternary care centre: a retrospective cohort study. |
title_fullStr |
Postoperative outcomes for Nunavut Inuit at a Canadian quaternary care centre: a retrospective cohort study. |
title_full_unstemmed |
Postoperative outcomes for Nunavut Inuit at a Canadian quaternary care centre: a retrospective cohort study. |
title_sort |
postoperative outcomes for nunavut inuit at a canadian quaternary care centre: a retrospective cohort study. |
publisher |
Canada |
publishDate |
2022 |
url |
https://hdl.handle.net/10137/12173 https://doi.org/10.9778/cmajo.20210108 https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/35504694 |
geographic |
Canada Nunavut |
geographic_facet |
Canada Nunavut |
genre |
inuit inuits Nunavut Qikiqtaaluk |
genre_facet |
inuit inuits Nunavut Qikiqtaaluk |
op_source |
10 |
op_relation |
© 2022 CMA Impact Inc. or its licensors. CMAJ Open. 2022 May 3;10(2):E304-E312. doi:10.9778/cmajo.20210108. Print 2022 Apr-Jun. 101620603 https://hdl.handle.net/10137/12173 CMAJ open doi:10.9778/cmajo.20210108 https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/35504694 |
op_doi |
https://doi.org/10.9778/cmajo.20210108 |
container_title |
CMAJ Open |
container_volume |
10 |
container_issue |
2 |
container_start_page |
E304 |
op_container_end_page |
E312 |
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1766044730953564160 |