Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-23T14:18:32.140Z Has data issue: false hasContentIssue false
  • English
  • Français

Survey of Preventable Disaster Death at Medical Institutions in Areas Affected by the Great East Japan Earthquake: A Retrospective Preliminary Investigation of Medical Institutions in Miyagi Prefecture

Published online by Cambridge University Press:  27 February 2015

Satoshi Yamanouchi ,
Hiroyuki Sasaki ,
Miho Tsuruwa ,
Yuzuru Ueki ,
Yoshitaka Kohayagawa ,
Hisayoshi Kondo ,
Yasuhiro Otomo ,
Yuichi Koido  and
Shigeki Kushimoto
Satoshi Yamanouchi*
Affiliation:
Emergency Center, Osaki Citizen Hospital, Osaki, Japan Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
Hiroyuki Sasaki
Affiliation:
Division of International Cooperation for Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
Miho Tsuruwa
Affiliation:
Institute for Clinical Research, National Disaster Medical Center, Tokyo, Japan
Yuzuru Ueki
Affiliation:
Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University, Tokyo, Japan
Yoshitaka Kohayagawa
Affiliation:
Institute for Clinical Research, National Disaster Medical Center, Tokyo, Japan
Hisayoshi Kondo
Affiliation:
Institute for Clinical Research, National Disaster Medical Center, Tokyo, Japan
Yasuhiro Otomo
Affiliation:
Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University, Tokyo, Japan
Yuichi Koido
Affiliation:
Institute for Clinical Research, National Disaster Medical Center, Tokyo, Japan
Shigeki Kushimoto
Affiliation:
Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
*
Correspondence: Satoshi Yamanouchi, MD, PhD Emergency Center Osaki Citizen Hospital 3-8-1 Honami, Furukawa, Osaki 989-6183, Japan E-mail: y-3104@yc4.so-net.ne.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Problem

The 2011, magnitude (M) 9, Great East Japan Earthquake and massive tsunami caused widespread devastation and left approximately 18,500 people dead or missing. The incidence of preventable disaster death (PDD) during the Great East Japan Earthquake remains to be clarified; the present study investigated PDD at medical institutions in areas affected by the Great East Japan Earthquake in order to improve disaster medical systems.

Methods

A total of 25 hospitals in Miyagi Prefecture (Japan) that were disaster base hospitals (DBHs), or had at least 20 patient deaths between March 11, 2011 and April 1, 2011, were selected to participate based on the results of a previous study. A database was created using the medical records of all patient deaths (n=868), and PDD was determined from discussion with 10 disaster health care professionals.

Results

A total of 102 cases of PDD were identified at the participating hospitals. The rate of PDD was higher at coastal hospitals compared to inland hospitals (62/327, 19.0% vs 40/541, 7.4%; P<.01). No difference was observed in overall PDD rates between DBHs and general hospitals (GHs); however, when analysis was limited to cases with an in-hospital cause of PDD, the PDD rate was higher at GHs compared to DBHs (24/316, 7.6% vs 21/552, 3.8%; P<.05). The most common causes of PDD were: insufficient medical resources, delayed medical intervention, disrupted lifelines, deteriorated environmental conditions in homes and emergency shelters at coastal hospitals, and delayed medical intervention at inland hospitals. Meanwhile, investigation of PDD causes based on type of medical institution demonstrated that, while delayed medical intervention and deteriorated environmental conditions in homes and emergency shelters were the most common causes at DBHs, insufficient medical resources and disrupted lifelines were prevalent causes at GHs.

Conclusion

Preventable disaster death at medical institutions in areas affected by the Great East Japan Earthquake occurred mainly at coastal hospitals. Insufficient resources (at GHs), environmental factors (at coastal hospitals), and delayed medical intervention (at all hospitals) constituted the major potential contributing factors. Further investigation of all medical institutions in Miyagi Prefecture, including those with fewer than 20 patient deaths, is required in order to obtain a complete picture of the details of PDD at medical institutions in the disaster area.

YamanouchiS, SasakiH, TsuruwaM, UekiY, KohayagawaY, KondoH, OtomoY, KoidoY, KushimotoS. Survey of Preventable Disaster Death at Medical Institutions in Areas Affected by the Great East Japan Earthquake: A Retrospective Preliminary Investigation of Medical Institutions in Miyagi Prefecture. Prehosp Disaster Med. 2015;30(2):1-7.

Keywords

disaster medicinedisaster-relief planningdisaster victimsearthquakestsunamis
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 2 , April 2015 , pp. 145 - 151
Copyright
© World Association for Disaster and Emergency Medicine 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Damage situation and police countermeasures associated with 2011 Tohoku district - off the Pacific Ocean Earthquake. National Police Agency of Japan Web site. https://www.npa.go.jp/archive/keibi/biki/higaijokyo_e.pdf. Accessed July 21, 2014.Google Scholar
2. A summary of the damage report of the Great East Japan Earthquak [in Japanese]. Fire and Disaster Management Agency Web site. http://www.fdma.go.jp/concern/publication/higashinihondaishinsai_kirokushu/pdf/honbun/03-01_02.pdf. Accessed July 21, 2014.Google Scholar
3. Lay, T, Kanamori, H, Ammon, CJ, et al. The Great Sumatra-Andaman Earthquake of 26 December 2004. Science. 2005;308(5725):1127-1133.Google Scholar
4. Chen, G, Lai, W, Liu, F, et al. The dragon strikes: lessons from the Wenchuan earthquake. Anesth Analg. 2010;110(3):908-915.Google Scholar
5. Watts, J. China’s health challenges after the earthquake. Lancet. 2008;371(9627):1825-1826.Google Scholar
6. Centers for Disease Control and Prevention. Deaths associated with Hurricane Sandy - October-November 2012. MMWR Morb Mortal Wkly Rep. 2013;62(20):393-397.Google Scholar
7. Nishiyama, Y. Disaster relief activities of the Japan Self-defense Force following the Great East Japan Earthquake. Disaster Med Public Health Prep. 2014;8(3):194-198.Google Scholar
8. Yamanouchi, S. Study on preventable disaster death in Miyagi Prefecture. Report of Ministry of Health, Labour, and Welfare Grant-in-Aid for Scientific Research Grant. “The study on disease structure and cause of death in the Great East Japan Earthquake Disaster,” (H24−Med−designation−036). 2014:43-45.Google Scholar
9. About improvement of primary emergency care system at the time of the disaster [in Japanese]. Ministry of Health, Labour, and Welfare Web site. http://www.mhlw.go.jp/stf/shingi/2r9852000001j51m-att/2r9852000001j5gi.pdf. Accessed July 21, 2014.Google Scholar
10. About the situation of the death caused by the Great East Japan Earthquake disaster judging from vital statistics [in Japanese]. Ministry of Health, Labour, and Welfare Web site. http://www.mhlw.go.jp/toukei/saikin/hw/jinkou/kakutei11/dl/14_x34.pdf. Accessed July 21, 2014.Google Scholar
11. Aoki, T, Fukumoto, Y, Yasuda, S, et al. The Great East Japan Earthquake disaster and cardiovascular diseases. Eur Heart J. 2012;33(22):2796-2803.Google Scholar
12. Kudo, D, Furukawa, H, Nakagawa, A, et al. Resources for business continuity in disaster-based hospitals in the Great East Japan Earthquake: survey of Miyagi Prefecture disaster base hospitals and the prefectural disaster medicine headquarters. Disaster Med Public Health Prep. 2013;7(5):461-466.Google Scholar