Racp Trainee Awards for Excellence in the Field of Adult Medicine

Abstract

Background and aim:Most information about stroke in Aboriginal/ Torres Strait Islander (Aboriginal) Australians comes from State hospital databases; data quality varies. Alice Springs Hospital is the sole hospital serving a large catchment in which 27% of inhabitants are Aboriginal people. It is ideally suited to the aim of this study, namely to compare stroke subtypes and outcomes between Aboriginal and non-Aboriginal people. Methods:We examined medical records of all Alice Springs Hospital stroke admissions (2011( -2014. Data were extracted using a pre-specified template. Clinical and radiological information was examined to assign a final stroke and aetiological classification.Results: Of 141 residents of Alice Springs admitted to hospital with first ever stroke during the study period, 58% were identified as Aboriginal. Stroke occurred in Aboriginal people at a younger age (mean 56.4 years) than non-Aboriginal people (mean 68.6 years, P < 0.001). Agestandardised stroke incidence was greater in Aboriginal people (172, 95% CI 147-198) than non-Aboriginal people (44, 95% CI 31-57; incidence rate ratio (IRR) 3.9, 95% CI 2.8-5.6), similarly in men and women.In those aged <55 years, stroke incidence was five-fold higher in Aboriginal people than non-Aboriginal people (5.13, 95% CI 2.37-12.66). Incidence of intracerebral haemorrhage in Aboriginal people was particularly excessive (IRR 6.7, 95% CI 3.0-17.6). Mortality was non-significantly higher (20% vs 8%, P = 0.085). Conclusion:Stroke incidence rates in Aboriginal people are excessive and occur at younger ages than non-Aboriginal people, with particular excess in intracerebral haemorrhage. Further work is required to reduce disparities in the occurrence of stroke. Background: Demand for deceased donor kidneys has exceeded supply in Australia over the past two decades. With a desire to utilise as many donor organs as possible, the health characteristics of accepted donors may have changed over time. TEMPORAL CHANGES IN DECEASED KIDNEY DONOR CHARACTERISTICS IN AUSTRALIA