Hurricane Sandy: Impact on Emergency Department and Hospital Utilization by Older Adults in Lower Manhattan, New York (USA)
Hurricane Sandy: Impact on Emergency Department and Hospital Utilization by Older Adults in Lower Manhattan, New York (USA)
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DOI：
10.1017/s1049023x15005087
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发表时间：
2015-10-01
影响因子：
2.2
通讯作者：
Habboushe, Joseph
中科院分区：
文献类型：
--
作者：
Gotanda, Hiroshi;Fogel, Joyce;Habboushe, Joseph
背景资料：2012年10月29日，飓风桑迪造成风暴潮，中断了曼哈顿（纽约，美国）的医疗基础设施。贝丝以色列医疗中心（BIMC）是桑迪飓风期间和之后曼哈顿下城唯一一家功能齐全的大型医院。研究了曼哈顿下城老年患者对急诊科（艾德）和医院使用的影响。实际停电期间桑迪后即刻阶段（IPS）的艾德就诊和住院趋势（2012年10月29日至11月4日），以及延长的后桑迪阶段（EPS），当时邻近的医院仍然无法工作（2012年11月5日至2013年2月10日）与基线进行分析。该分析按年龄组进行了细分（18-64岁、65-79岁和80岁以上），并包括艾德就诊和入院的原因。在实施综合预防措施期间，（65-79岁年龄组从11%增加到16.5%，80岁以上年龄组从6.5%增加到13%），（65-79岁年龄组从22.7%增至25.2%，80岁以上年龄组从17.6%增至33.8%）。然而，这些比例在EPS期间恢复至基线。在艾德就诊的老年患者中，“透析”、“呼吸装置”、“社交”和“晕厥”类别的比例显著高于年轻患者。“药物”、“透析”、“呼吸装置”和“社交”类别的增加占65-79岁年龄组艾德就诊和入院绝对增加的三分之二，占80岁以上年龄组艾德就诊绝对增加的一半。类别“社会”和“呼吸设备”达到峰值后一天的灾难，“透析”达到峰值后两天，“药物治疗”达到峰值后三天，在艾德访问analysis.Conclusions：有一个不成比例的增加，在艾德访问和住院的老年人口相比，年轻的人口在IPS。对老年人口造成不成比例影响的主要因素似乎是飓风的间接影响，主要是由于随后的停电，如“透析”，“呼吸装置”和“社会”。“通过图表审查进行的进一步调查可能会提供更多的见解，以更好地帮助未来的备灾工作。
Background: On October 29th, 2012, Hurricane Sandy caused a storm surge interrupting electricity with disruption to Manhattan's (New York, USA) health care infrastructure. Beth Israel Medical Center (BIMC) was the only fully functioning major hospital in lower Manhattan during and after Hurricane Sandy. The impact on emergency department (ED) and hospital use by geriatric patients in lower Manhattan was studied.Methods: The trends of ED visits and hospitalizations in the immediate post-Sandy phase (IPS) during the actual blackout (October 29 through November 4, 2012), and the extended post-Sandy phase (EPS), when neighboring hospitals were still incapacitated (November 5, 2012 through February 10, 2013), were analyzed with baseline. The analysis was broken down by age groups (18-64, 65-79, and 80+ years old) and included the reasons for ED visits and admissions.Results: During the IPS, there was a significant increase in geriatric visits (from 11% to 16.5% in the 65-79 age group, and from 6.5% to 13% in the 80+ age group) as well as in hospitalizations (from 22.7% to 25.2% in the 65-79 age group, and from 17.6% to 33.8% in the 80+ age group). However, these proportions returned to baseline during the EPS. The proportions of the categories "dialysis," "respiratory device,"social," and "syncope" in geriatric patients in ED visits were significantly higher than younger patients. The increases of the categories "medication," "dialysis," "respiratory device," and "social" represented two-thirds of absolute increase in both ED visits and admissions for the 65-79 age group, and half of the absolute increase in ED visits for the 80+ age group. The categories "social" and "respiratory device" peaked one day after the disaster, "dialysis" peaked two days after, and "medication" peaked three days after in ED visit analysis.Conclusions: There was a disproportionate increase in ED visits and hospitalizations in the geriatric population compared with the younger population during the IPS. The primary factor of the disproportionate impact on the geriatric population appears to be from indirect effects of the hurricane, mainly due to the subsequent power outages, such as "dialysis," "respiratory device," and "social." Further investigation by chart review may provide more insights to better aid with future disaster preparedness.