Burn injuries in native Canadians: a 10-year experience

Callegari, P; Alton, John; Shankowsky, Heather A.; Grace, M.

doi:10.1016/0305-4179(89)90062-4

Cited by 11 publications

(9 citation statements)

References 5 publications

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“…Surgical specialties included urologic (n = 8, 29%), 25,34,[40][41][42][43]45,46 obstetric (n = 5, 18%), 29,33,35,38 orthopedic (n = 3, 11%), 21,28,30,32 general (n = 3, 11%), 24,27,47 cardiac (n = 3, 11%), 22,39,44 ophthalmologic (n = 1, 4%), plastic (n = 1, 4%) and vascular (n = 1, 4%) surgery. 23,26,37 Three studies (11%) included a mix of surgical specialties. 31,36 All studies used observational designs (26 retrospective cohorts, 1 case-control, 1 crosssectional).…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies reported mortality rates (Table 2), 22,23,[26][27][28]39,43,47 including 4 studies that reported crude mortality data. 22,23,26,47 Overall, 47 (16.1%) of 292 people of Indigenous identity died, compared with 1209 (21.4%) of 5647 people of non-Indigenous identity; however, inadequate description of unadjusted data precluded meta-analysis. Meta-analysis of adjusted data estimated a pooled HR of 1.30 (95% confidence interval [CI] 1.09-1.54, I 2 = 81%), where an HR > 1 indicates a higher risk of death for Indigenous Peoples (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

“…24 We assessed quality of life after diabetic limb amputation and noted no difference between patients of First Nations or Métis identity and the rest of the study participants (decreased in both groups). 32 Citations from electronic search n = 1106 Twenty studies compared rates of surgery and wait times for Indigenous and non-Indigenous populations [20][21][22][23]25,[29][30][31][33][34][35][36][37][38][39]41,42,[44][45][46] (Appendix 5, available at www.cmaj.ca/lookup/doi/10.1503/ cmaj.191682/tab-related-content). Six studies evaluating rates of renal transplantation found that Indigenous Peoples with endstage renal disease were less likely to receive a transplant (HR 0.34-0.54).…”

Section: Discussionmentioning

confidence: 99%

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Postoperative outcomes for Indigenous Peoples in Canada: a systematic review

McVicar

Poon

Caron

et al. 2021

CMAJ

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Background: Substantial health inequities exist for Indigenous Peoples in Canada. The remote and distributed population of Canada presents unique challenges for access to and use of surgery. To date, the surgical outcome data for Indigenous Peoples in Canada have not been synthesized. Methods:We searched 4 databases to identify studies comparing surgical outcomes and utilization rates of adults of First Nations, Inuit or Métis identity with non-Indigenous people in Canada. Independ ent reviewers completed all stages in duplicate. Our primary outcome was mortality; secondary outcomes included utilization rates of surgical procedures, complications and hospital length of stay. We performed meta-analysis of the primary outcome using random effects models. We assessed risk of bias using the ROBINS-I tool.Results: Twenty-eight studies were reviewed involving 1 976 258 participants (10.2% Indigenous). No studies specifically addressed Inuit or Métis populations. Four studies, including 7 cohorts, contributed adjusted mortality data for 7135 participants (5.2% Indigenous); Indigenous Peoples had a 30% higher rate of death after surgery than non-Indigenous patients (pooled hazard ratio 1.30, 95% CI 1.09-1.54; I 2 = 81%). Complications were also higher for Indigenous Peoples, including infectious complications (adjusted OR 1.63, 95% CI 1.13-2.34) and pneumonia (OR 2.24,). Rates of various sur gical procedures were lower, including rates of renal transplant, joint replacement, cardiac surgery and cesarean delivery. Interpretation:The currently available data on postoperative outcomes and surgery utilization rates for Indigenous Peoples in Canada are limited and of poor quality. Available data suggest that Indigen ous Peoples have higher rates of death and adverse events after surgery, while also encountering barriers accessing surgical procedures. These findings suggest a need for substantial re-evaluation of surgical care for Indigenous Peoples in Canada to ensure equitable access and to improve outcomes. Protocol registration: PROSPERO-CRD42018098757 Disclaimer: Three of the authors identify as Indigenous: Jason McVicar (Métis), Nadine Caron (First Nations) and Donna May Kimmiliardjuk (Inuk).

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Postoperative outcomes for Indigenous Peoples in Canada: a systematic review

McVicar

Poon

Caron

et al. 2021

CMAJ

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“…With regards to pulmonary diseases, two articles mentioned increased mortality for Indigenous patients hospitalised for pneumonia [ 114 ] and COPD [ 40 ], two studies revealed no difference in mortality for H1N1 Influenza A and asthma [ 40 , 115 ] and three studies showed decreased mortality for Indigenous patients hospitalised for pneumonia [ 22 , 49 , 50 ]. For injuries and poisonings, two studies reported a higher mortality rate for Indigenous patients [ 57 , 60 ] and one study found no significant difference [ 116 ]. Studies reported no difference in mortality rates caused by strokes [ 75 ] or obstetrical diseases [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…For pulmonary diseases, two studies found no difference in the quality of care for people with lower respiratory tract infections [ 55 , 115 ] and one study concluded that Indigenous patients with asthma or COPD were 55% less likely to see a specialist and 66% less likely to have a spirometry [ 96 ]. For injuries, one study found that Indigenous patients wait longer for their follow-up [ 106 ], are less likely to opt for palliative health care and undergo more surgeries [ 116 ]. Two studies showed a decreased chance for Indigenous patients to consult a specialist for their health problem [ 48 , 120 ].…”

Section: Resultsmentioning

confidence: 99%

Acute health care among Indigenous patients in Canada: a scoping review

Vigneault

Diendéré

Sohier-Poirier

et al. 2021

International Journal of Circumpolar Health

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A recent report by the Chief Public Health Officer of Canada demonstrates the inferior health status of Indigenous Peoples in Canada when compared to non-Indigenous populations. This scoping review maps out the available literature concerning acute health care for Indigenous Peoples in Canada in order to better understand the health care issues they face. All existing articles concerning health care provided to Indigenous Peoples in Canada in acute settings were included in this review. The targeted studied outcomes were access to care, health care satisfaction, hospital visit rates, mortality, quality of care, length of stay and cost per hospitalisation. 114 articles were identified. The most studied outcomes were hospitalisation rates (58.8%), length of stay (28.0%), mortality (25.4%) and quality of care (24.6%) Frequently studied topics included pulmonary disease, injuries, cardiovascular disease and mental illness. Indigenous Peoples presented lower levels of satisfaction and access to care although they tend to be over-represented in hospitalisation rates for acute care. Greater inclusion of Indigenous Peoples in the health care system and in the training of health care providers is necessary to ensure a better quality of care that is culturally safe for Indigenous Peoples.

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Trends in Métis-related Health Research (1980–2009): Identification of Research Gaps

Kumar

Wesche

McGuire

2012

Can J Public Health

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étis are one of the three constitutionally recognized 1,2 and distinct Aboriginal Peoples in Canada, 3 and account for one third of the Aboriginal population with a self-identifying population of 389,785. 2 Most Métis (87%) live in Ontario and the western provinces, and in urban areas (69%). The Métis population has a lower median age (30 vs. 40 years), lower median income ($20,935 vs. $25,955), and lower rates of completion of postsecondary education (50% vs. 61%) than the non-Aboriginal population. 4 Métis are disproportionately affected by a range of diseases compared to the general population. Métis are less likely to report excellent or very good health (58% vs. 62%) and more likely to report arthritis/rheumatism (21% vs. 13%), high blood pressure (16% vs. 12%), asthma (14% vs. 8%), and diabetes (7 vs. 4%) compared to the total Canadian population. 2 A population-based study shows that Manitoba Métis have a higher prevalence of hypertension, arthritis, total respiratory morbidity, and ischemic heart disease, among other conditions, compared to all other Manitobans. Manitoba Métis also have a 21% higher premature mortality rate, 15% higher total mortality, and 12% higher diabetes-related mortality. 5 Despite their large population size, distinctness, and disproportionate burden of many diseases, Métis have been severely underrepresented in Aboriginal health and social sciences research. 6,7 A review of 254 Aboriginal-specific, medical/health sciences-related articles published between 1992 and 2001 identified only two papers (0.8%) that contained information on Métis. 6 A review of 96 social sciences-related articles (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005) revealed that only 14% were Métis-specific. 7 However, an in-depth examination of trends in Métis-related health/well-being research has not been undertaken. Identification of trends and gaps are important in guiding funding, recognizing and ameliorating other barriers to research, which, in turn, may lead to identification and development of interventions to tackle health disparities. To address this knowledge gap, a review of Métisrelated health and social sciences publications over the past three decades was carried out to identify trends and gaps in

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Burn injuries in native Canadians: a 10-year experience

Cited by 11 publications

References 5 publications

Postoperative outcomes for Indigenous Peoples in Canada: a systematic review

Postoperative outcomes for Indigenous Peoples in Canada: a systematic review

Acute health care among Indigenous patients in Canada: a scoping review

Trends in Métis-related Health Research (1980–2009): Identification of Research Gaps

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