Recent Immigrants to Canada More Likely to Die in ICU
MONDAY, Oct. 2, 2017 -- Recent immigrants to Canada are more likely to receive aggressive care and die in intensive care than long-standing residents, according to a study published online Oct. 2 in the Journal of the American Medical Association.
Christopher J. Yarnell, M.D., from the University of Toronto, and colleagues conducted a population-based cohort study to examine end-of-life care provided to immigrants to Canada in their last six months of life. Data were included for 967,013 decedents, of whom 5 percent had immigrated since 1985.
The researchers found that sex, socioeconomic status, urban residence, and causes of death were similar for immigrant and long-standing resident decedents, although long-standing residents were older (median, 75 versus 80 years). After adjustment for age, sex, income, geography, and cause of death, recent immigrant decedents were more likely to die in intensive care (15.6 versus 10 percent; relative risk, 1.3). Recent immigrants experienced more intensive care admissions (24.9 versus 19.2 percent), hospital admissions (72.1 versus 68.2 percent), mechanical ventilation (21.5 versus 13.6 percent), dialysis (5.5 versus 3.4 percent), percutaneous feeding tube placement (5.5 versus 3 percent), and tracheostomy (2.3 versus 1.1 percent) in their last six months of life. Compared with long-standing residents, the relative risk of dying in intensive care for recent immigrants varied according to region of birth.
"Further research is needed to understand the mechanisms behind this association," the authors write.
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Posted: October 2017