Kobayashi Seiichi, Hanagama Masakazu, Yamanda Shinsuke, Satoh Hikari, Tokuda Shinsaku, Kobayashi Masakazu, Ueda Shinsaku, Suzuki Satoshi, Yanai Masaru
Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki 986-8522, Japan.
Respir Investig. 2013 Mar;51(1):17-23. doi: 10.1016/j.resinv.2012.10.004. Epub 2012 Dec 27.
A large-scale natural disaster may exacerbate chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD). The aftermath of a natural disaster can include poor access to medication, medical equipment, and medical supplies. Little is known about the impact on patients with COPD.
A retrospective cohort study was conducted at a regional medical center in Ishinomaki, the area affected most severely by the Great East Japan Earthquake in 2011. The study was performed 6 months after the disaster. The characteristics, clinical courses, and outcomes of COPD patients hospitalized after emergency visits during the study period were investigated and compared.
One hundred patients (112 episodes) were identified. Within a few days after the disaster, patients undergoing oxygen therapy at home came to the hospital to receive oxygen. In the subacute phase (from the third to the fifth week), the number of hospitalizations due to COPD exacerbations was significantly increased compared to the numbers observed before the earthquake (p<0.05). On admission, COPD patients reported significantly reduced participation in the activities of daily living (ADLs) after as compared to before the disaster. The incidence of cases of exacerbated COPD normalized 6 weeks after the earthquake.
The large-scale natural disaster that hit Japan in 2011 had a serious negative impact on the clinical outcomes of COPD patients in the disaster-affected area.
大规模自然灾害可能会加重慢性呼吸道疾病,如慢性阻塞性肺疾病(COPD)。自然灾害的后果可能包括难以获得药物、医疗设备和医疗用品。关于对COPD患者的影响知之甚少。
在石卷市的一家区域医疗中心进行了一项回顾性队列研究,石卷市是2011年东日本大地震受灾最严重的地区。该研究在灾难发生6个月后进行。对研究期间急诊就诊后住院的COPD患者的特征、临床病程和结局进行了调查和比较。
共确定了100名患者(112次发病)。灾难发生后的几天内,在家接受氧疗的患者前来医院吸氧。在亚急性期(第三至第五周),与地震前观察到的住院人数相比,因COPD急性加重而住院的人数显著增加(p<0.05)。入院时,COPD患者报告称,与灾难前相比,日常生活活动(ADL)的参与度显著降低。地震6周后,COPD急性加重病例的发生率恢复正常。
2011年袭击日本的大规模自然灾害对受灾地区COPD患者的临床结局产生了严重的负面影响。