Causes of Excess Deaths in Puerto Rico After Hurricane Maria: A Time-Series Estimation
Causes of Excess Deaths in Puerto Rico After Hurricane Maria: A Time-Series Estimation
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DOI：
10.2105/ajph.2019.305015
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发表时间：
2019-07-01
影响因子：
12.7
通讯作者：
Mead, Erin L.
中科院分区：
文献类型：
--
作者：
Cruz-Cano, Raul;Mead, Erin L.
目标.为了确定飓风玛丽亚于2017年9月20日登陆后波多黎各超额死亡的人数和原因。我们获得了2008年1月至2017年10月期间所有死亡的每月生命统计数据。我们进行了一项时间序列分析，以估计2017年9月和10月的总体超额死亡率，并按年龄，性别和死因进行分析。我们估计总共有1205例额外死亡（95%置信区间[CI]= 707，1702）。男性的超额死亡人数略高于女性（分别为632人和579人），仅在60岁或60岁以上的人群中发现（1 038人死亡）。大多数额外死亡发生在心脏病（253例死亡）、“其他”原因（204例死亡）、糖尿病（195例死亡）、阿尔茨海默病（122例死亡）和败血症（81例死亡）。超额死亡人数与政府最近的估计相似。然而，这项研究是第一次确定灾难加剧的死亡原因。公共卫生影响。准确估计死亡率过高的主要原因可以帮助当局规划资源分配，用于该岛的恢复和预防未来灾害中的死亡。
Objectives. To determine the number and causes of excess deaths in Puerto Rico after Hurricane Maria made landfall on September 20, 2017.Methods. We obtained monthly vital statistics data on all deaths from January 2008 through October 2017. Weconducted a time-series analysis to estimate excess mortality in September and October 2017 overall and by age, sex, and cause of death.Results. We estimated a total of 1205 excess deaths (95% confidence interval [CI]= 707, 1702). Excess deaths were slightly higher among men than women (632 and 579 deaths, respectively) and found only among people aged 60 years or older (1038 deaths). Most excess deaths occurred from heart disease (253 deaths), "other" causes (204 deaths), diabetes (195 deaths), Alzheimer's disease (122 deaths), and septicemia (81 deaths).Conclusions. The number of excess deaths was similar to recent government estimates. However, this study is the first to identify the causes of death that were exacerbated by the disaster. Public Health Implications. An accurate estimation of the top causes of excess mortality can help authorities plan resource allocation for the island's recovery and for the prevention of deaths in future disasters.