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

Published online by Cambridge University Press:  24 April 2020

Ediel O. Ramos-Meléndez ,
Mariely Nieves-Plaza ,
Julio López-Maldonado ,
Laura Ramírez-Martínez ,
Lourdes Guerrios  and
Pablo Rodríguez-Ortiz
Ediel O. Ramos-Meléndez
Affiliation:
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
Mariely Nieves-Plaza
Affiliation:
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
Julio López-Maldonado
Affiliation:
Puerto Rico Trauma Hospital, San Juan, Puerto Rico
Laura Ramírez-Martínez
Affiliation:
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
Lourdes Guerrios
Affiliation:
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
Pablo Rodríguez-Ortiz*
Affiliation:
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
*
Correspondence and reprint requests to Pablo Rodríguez-Ortiz, Puerto Rico Trauma Hospital, University of Puerto Rico, P.O. Box 365067 San Juan PR 00936 (e-mail: pablo.rodriguez5@upr.edu).
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Abstract

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.

Keywords

hurricanehurricane related injuriesmortalitytrauma
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e3
Copyright
Copyright © 2020 Society for Disaster Medicine and Public Health, Inc.

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