Survival and cost analysis of fatalities of the Kobe earthquake in Japan.
Survival and cost analysis of fatalities of the Kobe earthquake in Japan.
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DOI：
10.1016/j.prehos.2003.12.019
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发表时间：
2004-04-01
期刊：
影响因子：
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通讯作者：
Fukui, Tsuguya
中科院分区：
文献类型：
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作者：
Aoki, Noriaki;Nishimura, Akiyoshi;Fukui, Tsuguya
目的：作者调查了死亡模式，死亡的原因和可预防性在一个大地震灾害，并估计所需的费用，以加强紧急医疗服务（EMS）的反应，以防止“不必要的”deaths.METHODS：作者回顾了1995年坂神淡路（科比）地震的尸检数据。进行生存分析，以确定这些死亡的时间进程和死亡模式。还进行了成本分析，以估计EMS减少死亡的可接受成本。潜在的可挽救的生命年的基础上预期寿命年的死亡人数进行了计算，并用于模拟一个增强的EMS灾难responsibility.RESULTS的可接受的成本：作者分析了5,411死亡。超过80%的患者在3小时内死亡。不同死因的生存/死亡模式存在统计学显著差异。13%的受害者经历了长期死亡，这本可以通过早期的医疗或手术干预来预防。这些失去的生命的货币成本估计约为600万美元dollars.CONCLUSIONS：生存分析显示，一个潜在的可挽救的患者，如果更及时和适当的医疗干预，地震后立即提供了显着的人口。根据我们的成本分析，并假设每年发生地震的概率为1%，EMS的救生能力提高了30%，每年约$万美元的支出是实现减少灾害中可预防死亡目标的合理支出。
OBJECTIVES: The authors investigated the dying patterns, and cause and preventability of deaths in a major earthquake disaster, and estimated the cost needed to enhance emergency medical services (EMS) response to prevent "unnecessary" deaths.METHODS: The authors reviewed autopsy data in the Hanshin-Awaji (Kobe) earthquake of 1995. A survival analysis was performed to determine the time course and pattern of dying of these deaths. A cost analysis to estimate acceptable cost for EMS to reduce fatalities was also performed. Potentially salvageable life-years based on expected life-years among fatalities were calculated and used to simulate an acceptable cost for an enhanced EMS disaster response.RESULTS: The authors analyzed 5,411 fatalities. More than 80% of these patients died within three hours. There were statistically significant differences in survival/dying patterns among causes of death. Thirteen percent of victims experienced a protracted death, which could have been prevented with earlier medical or surgical intervention. The monetary cost of these lost lives was estimated at approximately 600 million US dollars.CONCLUSIONS: Survival analysis revealed a significant population of potentially salvageable patients if more timely and appropriate medical intervention had been available immediately after the earthquake. Based on our cost analysis, and assuming a 1% annual probability of an earthquake and a 30% enhanced lifesaving capability of the EMS effort, approximately $ million dollars annually could be a reasonable expenditure to achieve the goal of reducing preventable deaths in disasters.