Heart and Vascular Institute, Tulane University, New Orleans, Louisiana, USA.
Am J Cardiol. 2012 Feb 15;109(4):502-5. doi: 10.1016/j.amjcard.2011.09.045. Epub 2011 Dec 6.
To detect a long-term increase in the incidence of acute myocardial infarction (AMI) after Hurricane Katrina and to investigate the pertinent contributing factors, we conducted a single-center retrospective cohort observational study. The patients admitted with AMI to Tulane University Hospital in the 2 years before Katrina and the 3 years after the hospital reopened were identified from the hospital medical records. The pre- and post-Katrina groups were compared for prespecified demographic and clinical data. In the 3-year post-Katrina group, 418 admissions (2.0%) for AMI occurred of a total census of 21,092 patients compared to 150 (0.7%) of a census of 21,079 in the 2-year pre-Katrina group (p <0.0001). The post-Katrina group had a greater prevalence of unemployment (p <0.0001), lack of medical insurance (p <0.001), smokers (p <0.01), medical noncompliance (p <0.0001), first-time hospitalizations (p <0.001), history of coronary artery disease (p <0.01), multiple vessel disease (p <0.05), and percutaneous coronary interventions (p <0.0001). The mean age of onset of AMI decreased from 62 years before Katrina to 59 years after Katrina (p <0.05), and a significantly greater percentage of patients were men (p <0.05). No significant differences were found between the two groups in terms of race, substance abuse, and a history of hypertension or diabetes mellitus. Our data suggest that chronic stress after natural disasters may significantly affect cardiovascular risk factors such as tobacco abuse and increase medical noncompliance. In conclusion, our data is consistent with a significant change in the overall health of the population and support the need for additional study into the health effects of chronic stress after natural disasters.
为了检测卡特里娜飓风后急性心肌梗死（AMI）发病率的长期增加，并调查相关的致病因素，我们进行了一项单中心回顾性队列观察研究。从医院病历中确定了在卡特里娜飓风前 2 年和医院重新开放后 3 年期间因 AMI 住院的患者。比较了飓风前后两组患者的预设人口统计学和临床数据。在 3 年的卡特里娜飓风后组中，21092 例患者中共有 418 例（2.0%）因 AMI 入院，而在 2 年的卡特里娜飓风前组中，21079 例患者中有 150 例（0.7%）因 AMI 入院（p<0.0001）。飓风后组的失业率更高（p<0.0001），缺乏医疗保险（p<0.001），吸烟者更多（p<0.01），不遵守医嘱的情况更常见（p<0.0001），首次住院的情况更常见（p<0.001），冠心病病史更多（p<0.01），多血管疾病（p<0.05）和经皮冠状动脉介入治疗（p<0.0001）更多。AMI 发病的平均年龄从卡特里娜飓风前的 62 岁下降到了飓风后的 59 岁（p<0.05），且男性患者的比例显著增加（p<0.05）。两组患者在种族、药物滥用以及高血压或糖尿病病史方面没有显著差异。我们的数据表明，自然灾害后的慢性压力可能会显著影响心血管危险因素，如吸烟和不遵守医嘱的情况。总之，我们的数据与人口整体健康状况的显著变化一致，并支持对自然灾害后慢性压力对健康的影响进行更多研究。
