Cheok, Tim

Bastick, Kate

George, Daniel

Chan, Teik Seng

Jaitly, Aayush

Jayasekera, Narlaka

Bray, Linda

Poonnoose, Pradeep Mathew

Williams, Kanishka

2024-06-07

Australian Indigenous (AI) populations face significant socioeconomic disadvantage and have poorer health outcomes when compared to their non-AI counterparts. There is a paucity of published literature on outcomes following hip fracture in the AI population.We performed a retrospective cohort study comparing outcomes following hip fracture in AI and non- AI patients presenting to a single regional trauma centre. The primary outcome of interest was all-cause mortality. Secondary outcomes of interest were the odds of postoperative delirium and length of stay in hospital. All outcomes were adjusted against collected baseline covariates.One hundred and twenty-seven hip fractures were identified across 125 patients. There were 62 hip fractures in the AI group and 65 in the non-AI group. The adjusted hazard ratio (HR) for all-cause mortality was not statistically significant when comparing Indigenous versus non-Indigenous patients (HR = 2.37, P = 0.055). Adjusted odds of postoperative delirium was lower in Indigenous patients (OR = 0.12; P = 0.018). The AI cohort had a 4 day longer median length of stay, which was not statistically significant when adjusted for covariates.AI patients with hip fractures were younger, had a higher Charlson Comorbidity Index Score and American Society of Anaesthesiologists grade, as well as a higher incidence of diabetes and associated end-organ sequalae. There was no difference in all-cause mortality. Odds of postoperative delirium was lower in the AI group. We did not find any difference in the length of hospital stay.

Department of Orthopaedic Surgery, Lyell McEwin Hospital, Adelaide, South Australia, Australia.

College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

Department of Orthopaedic Surgery, Lyell McEwin Hospital, Adelaide, South Australia, Australia.

College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

Department of Orthopaedic Surgery, Lyell McEwin Hospital, Adelaide, South Australia, Australia.

Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

Department of Orthopaedic Surgery, Wairau Hospital, Blenheim, New Zealand.

Aboriginal Liaison Services, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

Department of Orthopaedic Surgery, Christian Medical College Hospital, Vellore, India.

College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

ANZ J Surg . 2024 Jun 7. doi: 10.1111/ans.19120. Online ahead of print.

1445-2197

0000-0003-1215-9361

https://pubmed.ncbi.nlm.nih.gov/38845600/?otool=iaurydwlib

https://hdl.handle.net/10137/13400

hip fracture

indigenous health

mortality

orthopaedic surgery

A retrospective cohort study comparing outcomes following hip fractures in Australian indigenous patients with non-Australian indigenous patients.

Journal Article

Publication