Unveiling the Natural History of Category 4 Tropical Cyclones: The Puerto Rico Trauma Hospital Experience after Hurricane Maria.

Autor:	Ramos-Meléndez EO; Department of Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.; Puerto Rico Trauma Hospital, San Juan, Puerto Rico., Nieves-Plaza M; Department of Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.; Puerto Rico Trauma Hospital, San Juan, Puerto Rico., López-Maldonado J; Puerto Rico Trauma Hospital, San Juan, Puerto Rico., Ramírez-Martínez L; Department of Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.; Puerto Rico Trauma Hospital, San Juan, Puerto Rico., Guerrios L; Department of Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.; Puerto Rico Trauma Hospital, San Juan, Puerto Rico., Rodríguez-Ortiz P; Department of Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.; Puerto Rico Trauma Hospital, San Juan, Puerto Rico.
Jazyk:	angličtina
Zdroj:	Disaster medicine and public health preparedness [Disaster Med Public Health Prep] 2020 Apr 24; Vol. 17, pp. e3. Date of Electronic Publication: 2020 Apr 24.
DOI:	10.1017/dmp.2020.41
Abstrakt:	Objectives: The hazardous environmental conditions hurricanes create might increase injury incidence almost 7 times. Therefore, a cohort study was performed at the Puerto Rico Trauma Hospital to compare morbidity and mortality patterns of patients after Hurricane Maria with a control period. Methods: Admissions from September 20, 2017, through January 20, 2018, constituted the post-Maria period (473 patients); the corresponding months of the previous year comprised the pre-Maria period (439 patients). Comparisons were done using Pearson's chi-square or Mann-Whitney U-tests, as appropriate. A logistic regression was performed to assess the association between mortality and the study period. Results: Postlandfall admissions among patients aged 40-64 y increased by 6.6%, while among subjects between ages 18 and 39 y dropped by 7.0% ( P = 0.03). Falls, gunshots, and burns were the injury mechanisms that varied the most across the exposure period. The median Injury Severity Score (13 vs 12; P = 0.05) and the frequency of Glasgow Coma Scale scores ≤8 (17.1% vs 10.9%; P = 0.03) were higher among poststorm patients. Moreover, a 2-fold (odds ratio = 1.93; 95% CI: 1.07-3.47) increase in mortality was observed after Maria, when adjusting for covariates. Conclusions: Following a hurricane, trauma centers might expect an older population, with more severe injuries and a 2-fold increased mortality risk.
Databáze:	MEDLINE
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