A study from an Ottawa hospital suggests that Nunavut Inuit are 25 per cent more likely to experience complications after surgery than non-Inuit patients, a result researchers say may be because of barriers to timely and culturally sensitive health care.
The study, published Tuesday in the online health journal CMAJ Open, involved adult patients at The Ottawa Hospital from 2011 to 2018. The hospital is one of the main care providers to the Qikiqtani region in northeastern Nunavut, home to half the territory’s Inuit population.
“We want the take-home message to still be that if you need care in Ottawa, or if you need surgery in Ottawa, it is still very safe to do so,” said Dr. Donna May Kimmaliardjuk, study author and Inuk cardiac surgeon.
The study comes a year after a systemic review found that Indigenous people faced a 30 per cent higher death rate after surgery compared with non-Indigenous patients in Canada. The authors of that review also analyzed literature that indicated Indigenous patients suffered higher rates of surgical complications, including post-operative infections and readmissions to hospital.
Dr. Jason McVicar, lead author of both studies, said last year’s review showed there was no data that specifically pertained to Inuit and Métis communities.
“We found that there was this gap,” said McVicar, a Métis anesthesiologist at The Ottawa Hospital.
“We decided to look at seven years worth of data, where we were able to look at all the surgeries that occurred in Ottawa at that time and see what kind of outcomes we were able to measure.”
Researchers were able to identify Nunavut Inuit by a code in their health-card number that indicated they were a land-claim beneficiary. Inuit patients from Nunavut made up 928 of 98,701 surgeries.
The study looked at outcomes one month after surgery for all in-patients, not including obstetric or cardiac surgeries. There was no difference in outcomes after emergency surgery between Inuit and non-Inuit patients.
But McVicar noted Nunavut Inuit patients who had elective surgeries were 58 per cent more likely to have complications and 63 per cent more likely to have complications after cancer surgeries.
Kimmaliardjuk said poor access to care in Nunavut is most likely to be the reason behind those figures.
“When you have lack of access to timely and culturally appropriate care, you are then getting delays in your diagnosis and delays in your surgery, which means you are coming to surgery with more advance stages of your disease,” she said.
“As a surgeon, when you have someone coming to you sicker, that makes the surgery that much harder and increases your risk of complications.”
The research team is looking at expanding the kinds of surgeries that can be done in Nunavut, so patients can receive care closer to home. The Ottawa Hospital and University of Ottawa already have partnerships with general surgery teams in Iqaluit.
For many people in Nunavut, receiving care in Ottawa could be likened to someone in Ontario going to Mexico City for surgery, McVicar said.
“In terms of distance travel, climate difference, language, culture, the isolation … (those) challenges would be unfathomable for some people,” he said. “For Inuit in Nunavut, that is an everyday occurrence.”
Kimmaliardjuk said she would like to see more health screening services in Nunavut, as well as expanded telehealth services with specialists.
“We have real numbers that we didn’t have before that we can show to legislatures, to government, to organizations and policy-makers that say, ‘Look, these are the outcomes. This is where and why we should be investing our resources and our money.”
This report by The Canadian Press was first published May 3, 2022.
Daniela Germano, The Canadian Press