M¯aori youth death rate higher after major trauma

Ma¯ ori aged 15-18 are three times more likely to die in the 30 days following a major trauma than non-Ma¯ ori, a report has found.

A watchdog is now calling for health boards to review all cases of major trauma resulting in Ma¯ ori youth being hospitalised.

The Perioperative Mortality Review Committee (POMRC) report, released yesterday, compared outcomes for Ma¯ori and non-Ma¯ ori in the 30 days following major trauma.

The committee reviews deaths related to surgery and anaesthesia within 30 days following an operation. It advises the Health Quality and Safety Commission on how to reduce those deaths, and makes recommendations to make surgery safer for patients.

The report found Ma¯ ori were 37 per cent more likely than nonMa¯ori not to get an initial CT scan, and were 56 per cent more likely to die in the first 30 days following major trauma that did not involve serious traumatic brain injury (TBI).

The main analysis found no inequities for Ma¯ori in overall mortality following major trauma, but inequity was ‘‘clear’’ among Ma¯ ori youth, it said.

This was not explained by differences in gender, time to receive care, helicopter transfer to hospital, whether the injury location was urban or rural, whether the patient received an index CT scan, or whether there was a serious TBI. Part, but not all, of the inequity in mortality in young people was due to trauma severity, it found.

The committee recommended each DHB conduct an in-depth local review this year of all case of trauma in Ma¯ ori aged 15-18 years that occurred in 2018-20.

‘‘The review should focus on whether treatment was optimal and timely, and what systems and processes need to be improved to provide high-quality and equitable care,’’ the report said.

It also recommended DHBs review all cases of people with serious traumatic brain injury treated at non-neurological centres, focusing on how appropriate and effective decisions about whether to transfer patients were.

Committee member Dr Dick Ongley said the report’s recommendations aim to help improve understanding of factors that contribute to inequities in outcomes in the health system.

Inequity was ‘‘clear’’ among Ma¯ori youth. Perioperative Mortality Review Committee report