ArticleJournal of the colleges of medicine of South Africa2026
Public versus private trauma intensive care unit outcomes: A retrospective cohort study.
Article in Journal of the colleges of medicine of South Africa, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Trauma remains a leading cause of morbidity and mortality in low- and middle-income countries (LMICs), with South Africa experiencing a high burden of intentional and high-energy injuries. Disparities in critical care resources between the public and private healthcare sectors have been reported, but comparative trauma intensive care unit (ICU) outcomes remain incompletely described. Methods: This retrospective cohort study compared adult trauma patients admitted to public and private healthcare sector ICUs in Johannesburg between July 2022 and June 2023. The primary outcome was 30-day in-hospital mortality. Secondary outcomes included injury characteristics, severity of illness and factors associated with mortality. Descriptive statistics and multivariate logistic regression were used for data analysis. Results: A total of 453 trauma patients were included (private ICU Conclusion: Despite differences in injury profiles, patient mortality was similar in both healthcare sectors. Illness severity remains the prevailing determinant of outcome, underscoring the importance of severity scoring systems and potential system-level factors in LMICs' trauma care. Level of evidence: Level III; prognostic and epidemiological study. Contribution: This study provides comparative trauma ICU outcomes data from the public and private healthcare sectors in Johannesburg, highlighting the role of illness severity and healthcare sector infrastructure on patient mortality and informing trauma critical care in LMICs.
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